Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.18 / $213.79 / $223.21	Facility		$94.18	$213.79	$223.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.71 / $94.18 / $223.21	Professional		$83.71	$94.18	$223.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $122.20 / $290.74 / $703.87	Facility		$122.20	$290.74	$703.87
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $101.88 / $121.42 / $831.20	Professional		$101.88	$121.42	$831.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.28 / $90.28 / $90.28	Facility		$90.28	$90.28	$90.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.90 / $65.90 / $90.28	Professional		$65.90	$65.90	$90.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $87.81 / $148.41 / $382.41	Facility		$87.81	$148.41	$382.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.91 / $149.35 / $296.24	Professional		$87.91	$149.35	$296.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.29 / $106.99 / $117.68	Professional		$96.29	$106.99	$117.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $110.78 / $136.29 / $152.87	Facility		$110.78	$136.29	$152.87
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $132.58 / $139.56 / $152.87	Professional		$132.58	$139.56	$152.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.20 / $156.72 / $272.58	Facility		$122.20	$156.72	$272.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $132.83 / $136.29 / $136.29	Facility		$132.83	$136.29	$136.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $110.87 / $118.63 / $153.52	Professional		$110.87	$118.63	$153.52
United Facility/Professional Professional Modifier Low / Median / High Price $64.37 / $72.06 / $132.83	Professional		$64.37	$72.06	$132.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.52 / $79.52 / $81.72	Professional		$79.52	$79.52	$81.72