Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.45 / $195.78 / $308.61	Professional		$166.45	$195.78	$308.61
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,757.61 / $1,757.61	Facility		$100.00	$1,757.61	$1,757.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $32.07 / $288.20 / $382.40	Professional		$32.07	$288.20	$382.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $240.50 / $240.50 / $240.50	Facility		$240.50	$240.50	$240.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.06 / $204.43 / $240.50	Professional		$29.06	$204.43	$240.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $386.40 / $386.40 / $386.40	Facility		$386.40	$386.40	$386.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $386.40 / $386.40 / $386.40	Professional		$386.40	$386.40	$386.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $245.52 / $306.89 / $337.59	Professional		$245.52	$306.89	$337.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $546.15 / $656.00 / $665.31	Facility		$546.15	$656.00	$665.31
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $546.15 / $656.00 / $665.31	Professional		$546.15	$656.00	$665.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.83 / $33.83 / $33.83	Facility		$33.83	$33.83	$33.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.07 / $320.70 / $680.25	Professional		$32.07	$320.70	$680.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $26.09 / $26.09 / $31.77	Professional		$26.09	$26.09	$31.77
United Facility/Professional Professional Modifier Low / Median / High Price $131.72 / $164.78 / $274.64	Professional		$131.72	$164.78	$274.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $20.35 / $20.35	Professional		$20.35	$20.35	$20.35