Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.18 / $145.69 / $152.11	Facility		$64.18	$145.69	$152.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.77 / $64.18 / $152.11	Professional		$52.77	$64.18	$152.11
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $83.28 / $279.75 / $494.49	Facility		$83.28	$279.75	$494.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $68.70 / $83.28 / $884.34	Professional		$68.70	$83.28	$884.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.37 / $81.37 / $81.37	Facility		$81.37	$81.37	$81.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.40 / $59.40 / $81.37	Professional		$59.40	$59.40	$81.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $59.15 / $100.75 / $260.61	Facility		$59.15	$100.75	$260.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.21 / $101.25 / $200.25	Professional		$59.21	$101.25	$200.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.61 / $72.91 / $80.20	Professional		$65.61	$72.91	$80.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.48 / $92.88 / $95.11	Facility		$75.48	$92.88	$95.11
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $85.60 / $95.11 / $95.11	Professional		$85.60	$95.11	$95.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.28 / $106.81 / $185.76	Facility		$83.28	$106.81	$185.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.95 / $78.95 / $78.95	Professional		$78.95	$78.95	$78.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $90.53 / $92.88 / $92.88	Facility		$90.53	$92.88	$92.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $75.55 / $80.84 / $104.62	Professional		$75.55	$80.84	$104.62
United Facility/Professional Professional Modifier Low / Median / High Price $43.46 / $47.08 / $89.69	Professional		$43.46	$47.08	$89.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.31 / $33.31 / $57.29	Professional		$33.31	$33.31	$57.29