Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.54 / $77.42 / $92.67	Facility		$61.54	$77.42	$92.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.92 / $61.54 / $77.42	Professional		$57.92	$61.54	$77.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $63.96 / $100.42 / $329.55	Facility		$63.96	$100.42	$329.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $61.39 / $2,649.11 / $2,649.11	Professional		$61.39	$2,649.11	$2,649.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.54 / $62.23 / $150.91	Facility		$61.54	$62.23	$150.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $61.54 / $61.54	Professional		$61.54	$61.54	$61.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.97 / $102.68 / $208.82	Facility		$57.97	$102.68	$208.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.19 / $95.22 / $167.68	Professional		$57.19	$95.22	$167.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $66.37 / $80.00	Professional		$60.00	$66.37	$80.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $106.17 / $79,999.20 / $79,999.20	Facility		$106.17	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.56 / $97.85 / $179.08	Facility		$57.56	$97.85	$179.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.75 / $61.54 / $76.02	Professional		$55.75	$61.54	$76.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $63.96 / $79.95 / $145.52	Facility		$63.96	$79.95	$145.52
United Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $60.34 / $72.41	Professional		$60.34	$60.34	$72.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $60.34 / $60.34	Professional		$60.34	$60.34	$60.34