Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $46.26 / $104.41	Professional		$39.54	$46.26	$104.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $411.79 / $411.79	Facility		$100.00	$411.79	$411.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $13.09 / $69.14 / $111.39	Professional		$13.09	$69.14	$111.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.45 / $57.45 / $76.92	Facility		$57.45	$57.45	$76.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.83 / $57.45 / $107.15	Professional		$48.83	$57.45	$107.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $82.92 / $82.92 / $82.92	Facility		$82.92	$82.92	$82.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $82.92 / $82.92 / $82.92	Professional		$82.92	$82.92	$82.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.72 / $92.15 / $101.36	Professional		$73.72	$92.15	$101.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.09 / $82.92 / $117.98	Facility		$79.09	$82.92	$117.98
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $79.09 / $82.92 / $116.69	Professional		$79.09	$82.92	$116.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $8.86 / $80.04 / $80.04	Facility		$8.86	$80.04	$80.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.84 / $81.64 / $99.82	Professional		$6.84	$81.64	$99.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $10.75 / $10.75 / $13.09	Professional		$10.75	$10.75	$13.09
United Facility/Professional Professional Modifier Low / Median / High Price $43.33 / $58.97 / $83.23	Professional		$43.33	$58.97	$83.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $96.15 / $96.15 / $96.15	Professional		$96.15	$96.15	$96.15