Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.77 / $58.30 / $99.84	Facility		$52.77	$58.30	$99.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $48.45 / $58.08	Professional		$47.97	$48.45	$58.08
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $47.97 / $72.87 / $241.15	Facility		$47.97	$72.87	$241.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $47.97 / $213.78	Professional		$47.97	$47.97	$213.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.26 / $45.26 / $47.97	Facility		$45.26	$45.26	$47.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $47.97 / $58.83	Professional		$47.97	$47.97	$58.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.97 / $47.97 / $156.40	Facility		$47.97	$47.97	$156.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $47.97 / $88.11	Professional		$47.97	$47.97	$88.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $52.80 / $75.00	Professional		$47.97	$52.80	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.97 / $48.00 / $85.38	Facility		$47.97	$48.00	$85.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.49 / $76.18 / $136.03	Facility		$42.49	$76.18	$136.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.16 / $53.45 / $93.64	Professional		$51.16	$53.45	$93.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $47.97 / $58.30 / $106.70	Facility		$47.97	$58.30	$106.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $45.57 / $47.97 / $49.89	Professional		$45.57	$47.97	$49.89
United Facility/Professional Facility Modifier Low / Median / High Price $79.58 / $79.58 / $79.58	Facility		$79.58	$79.58	$79.58
United Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $47.97 / $49.41	Professional		$47.97	$47.97	$49.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $47.97 / $48.42	Professional		$47.97	$47.97	$48.42