Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.18 / $243.49 / $519.14	Professional		$230.18	$243.49	$519.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $462.12 / $2,149.42 / $2,149.42	Facility		$462.12	$2,149.42	$2,149.42
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $41.50 / $345.47 / $522.62	Professional		$41.50	$345.47	$522.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.50 / $229.50 / $229.50	Facility		$229.50	$229.50	$229.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.08 / $229.50 / $393.05	Professional		$195.08	$229.50	$393.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $489.12 / $489.12 / $489.12	Facility		$489.12	$489.12	$489.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.12 / $489.12 / $489.12	Professional		$489.12	$489.12	$489.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $386.88 / $425.56	Professional		$75.00	$386.88	$425.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $460.35 / $489.12 / $520.40	Facility		$460.35	$489.12	$520.40
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $440.21 / $489.12 / $538.03	Professional		$440.21	$489.12	$538.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $546.11 / $664.83 / $831.04	Facility		$546.11	$664.83	$831.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $403.65 / $546.11	Professional		$40.36	$403.65	$546.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $474.88 / $474.88 / $474.88	Facility		$474.88	$474.88	$474.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $34.08 / $34.08 / $41.50	Professional		$34.08	$34.08	$41.50
United Facility/Professional Professional Modifier Low / Median / High Price $223.10 / $229.57 / $428.88	Professional		$223.10	$229.57	$428.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $343.12 / $343.12 / $343.12	Professional		$343.12	$343.12	$343.12