Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $361.17 / $763.36 / $2,316.62	Facility		$361.17	$763.36	$2,316.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.34 / $341.47 / $964.23	Professional		$328.34	$341.47	$964.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $397.51 / $743.19 / $5,222.64	Facility		$397.51	$743.19	$5,222.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $328.34 / $361.17 / $6,027.78	Professional		$328.34	$361.17	$6,027.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.75 / $324.80 / $787.64	Facility		$309.75	$324.80	$787.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.34 / $328.34 / $402.68	Professional		$328.34	$328.34	$402.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $328.34 / $772.59 / $2,907.25	Facility		$328.34	$772.59	$2,907.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $328.34 / $815.04 / $2,819.03	Professional		$328.34	$815.04	$2,819.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $333.21 / $394.00	Professional		$75.00	$333.21	$394.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.92 / $371.70 / $985.02	Facility		$302.92	$371.70	$985.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $521.75 / $1,023.42 / $1,872.93	Facility		$521.75	$1,023.42	$1,872.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.58 / $438.18 / $747.66	Professional		$361.58	$438.18	$747.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $397.51 / $596.27 / $1,232.28	Facility		$397.51	$596.27	$1,232.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $328.34 / $361.17 / $394.01	Professional		$328.34	$361.17	$394.01
United Facility/Professional Professional Modifier Low / Median / High Price $328.34 / $328.34 / $394.01	Professional		$328.34	$328.34	$394.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $324.80 / $328.34 / $328.34	Professional		$324.80	$328.34	$328.34