Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $395.60 / $405.84 / $680.49	Professional		$395.60	$405.84	$680.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,957.66 / $2,957.66	Facility		$100.00	$2,957.66	$2,957.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $84.79 / $649.41 / $860.22	Professional		$84.79	$649.41	$860.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.96 / $407.96 / $407.96	Facility		$407.96	$407.96	$407.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.77 / $407.96 / $586.66	Professional		$346.77	$407.96	$586.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $750.80 / $750.80 / $750.80	Facility		$750.80	$750.80	$750.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $750.80 / $750.80 / $750.80	Professional		$750.80	$750.80	$750.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.08 / $790.76 / $869.83	Professional		$95.08	$790.76	$869.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $919.05 / $1,016.57 / $1,119.57	Facility		$919.05	$1,016.57	$1,119.57
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $919.05 / $1,103.90 / $1,119.57	Professional		$919.05	$1,103.90	$1,119.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $71.23 / $71.23 / $71.23	Facility		$71.23	$71.23	$71.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.97 / $619.65 / $856.56	Professional		$61.97	$619.65	$856.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.64 / $69.64 / $84.79	Professional		$69.64	$69.64	$84.79
United Facility/Professional Professional Modifier Low / Median / High Price $361.84 / $469.22 / $603.05	Professional		$361.84	$469.22	$603.05