Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.91 / $176.86 / $184.65	Facility		$77.91	$176.86	$184.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.53 / $77.91 / $184.65	Professional		$52.53	$77.91	$184.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $101.10 / $245.41 / $496.97	Facility		$101.10	$245.41	$496.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $74.68 / $98.15 / $600.34	Professional		$74.68	$98.15	$600.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.68 / $71.68 / $71.68	Facility		$71.68	$71.68	$71.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.33 / $52.33 / $71.68	Professional		$52.33	$52.33	$71.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $59.15 / $112.46 / $268.12	Facility		$59.15	$112.46	$268.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.21 / $110.62 / $199.42	Professional		$59.21	$110.62	$199.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.65 / $88.51 / $97.36	Professional		$79.65	$88.51	$97.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.60 / $103.18 / $115.47	Facility		$91.60	$103.18	$115.47
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $91.72 / $115.47 / $115.47	Professional		$91.72	$115.47	$115.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $101.10 / $129.66 / $225.52	Facility		$101.10	$129.66	$225.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.85 / $95.85 / $95.85	Professional		$95.85	$95.85	$95.85
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $109.90 / $112.76 / $112.76	Facility		$109.90	$112.76	$112.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.72 / $98.15 / $127.02	Professional		$91.72	$98.15	$127.02
United Facility/Professional Facility Modifier Low / Median / High Price $125.07 / $150.08 / $150.08	Facility		$125.07	$150.08	$150.08
United Facility/Professional Professional Modifier Low / Median / High Price $43.27 / $46.79 / $89.28	Professional		$43.27	$46.79	$89.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.67 / $42.67 / $56.34	Professional		$42.67	$42.67	$56.34