Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $235.11 / $533.70 / $557.21	Facility		$235.11	$533.70	$557.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.53 / $235.11 / $311.58	Professional		$194.53	$235.11	$311.58
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $305.06 / $577.25 / $1,603.51	Facility		$305.06	$577.25	$1,603.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $245.27 / $307.68 / $1,729.95	Professional		$245.27	$307.68	$1,729.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.25 / $192.25 / $192.25	Facility		$192.25	$192.25	$192.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.34 / $140.34 / $192.25	Professional		$140.34	$140.34	$192.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $215.76 / $369.05 / $954.73	Facility		$215.76	$369.05	$954.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $215.76 / $355.36 / $659.64	Professional		$215.76	$355.36	$659.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $240.38 / $267.08 / $293.79	Professional		$240.38	$267.08	$293.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $330.97 / $340.22 / $348.39	Facility		$330.97	$340.22	$348.39
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $248.10 / $276.77 / $276.77	Professional		$248.10	$276.77	$276.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $289.19 / $305.06 / $663.43	Facility		$289.19	$305.06	$663.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $289.19 / $315.02 / $391.25	Professional		$289.19	$315.02	$391.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $331.60 / $340.22 / $340.22	Facility		$331.60	$340.22	$340.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $276.77 / $296.13 / $383.23	Professional		$276.77	$296.13	$383.23
United Facility/Professional Professional Modifier Low / Median / High Price $146.06 / $165.57 / $292.83	Professional		$146.06	$165.57	$292.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $183.63 / $183.63 / $183.63	Professional		$183.63	$183.63	$183.63