Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.80 / $92.10 / $142.74	Professional		$88.80	$92.10	$142.74
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $821.30 / $821.30	Facility		$100.00	$821.30	$821.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $17.68 / $136.59 / $213.50	Professional		$17.68	$136.59	$213.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.17 / $64.17 / $64.17	Facility		$64.17	$64.17	$64.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.75 / $54.54 / $106.86	Professional		$14.75	$54.54	$106.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $167.90 / $167.90 / $167.90	Facility		$167.90	$167.90	$167.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $167.90 / $167.90 / $167.90	Professional		$167.90	$167.90	$167.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $164.96 / $181.45	Professional		$75.00	$164.96	$181.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $211.10 / $240.90 / $293.45	Facility		$211.10	$240.90	$293.45
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $240.90 / $293.45 / $293.45	Professional		$240.90	$293.45	$293.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.58 / $15.58 / $15.58	Facility		$15.58	$15.58	$15.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.86 / $158.11 / $178.67	Professional		$13.86	$158.11	$178.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $14.52 / $14.52 / $17.68	Professional		$14.52	$14.52	$17.68
United Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $99.53 / $120.54	Professional		$72.31	$99.53	$120.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $136.59 / $136.59 / $148.77	Professional		$136.59	$136.59	$148.77