Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.59 / $79.56 / $152.97	Facility		$72.59	$79.56	$152.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $74.67 / $89.00	Professional		$73.94	$74.67	$89.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $66.59 / $104.94 / $351.90	Facility		$66.59	$104.94	$351.90
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $81.33 / $310.70	Professional		$73.94	$81.33	$310.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.75 / $70.37 / $170.65	Facility		$69.75	$70.37	$170.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $73.94 / $90.68	Professional		$73.94	$73.94	$90.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.62 / $76.84 / $179.54	Facility		$60.62	$76.84	$179.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.65 / $74.68 / $146.63	Professional		$59.65	$74.68	$146.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.38 / $77.41 / $95.01	Professional		$70.38	$77.41	$95.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $73.54 / $83.70 / $153.80	Facility		$73.54	$83.70	$153.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.22 / $101.88 / $186.44	Facility		$57.22	$101.88	$186.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.34 / $89.61 / $161.97	Professional		$74.34	$89.61	$161.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $69.95 / $81.33 / $139.91	Facility		$69.95	$81.33	$139.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $81.33 / $88.72	Professional		$73.94	$81.33	$88.72
United Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $73.94 / $88.73	Professional		$73.94	$73.94	$88.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.37 / $73.94 / $73.94	Professional		$70.37	$73.94	$73.94