Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.91 / $195.02 / $203.61	Facility		$85.91	$195.02	$203.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.28 / $85.91 / $203.61	Professional		$71.28	$85.91	$203.61
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $111.46 / $300.95 / $670.46	Facility		$111.46	$300.95	$670.46
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $92.92 / $124.31 / $840.16	Professional		$92.92	$124.31	$840.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.21 / $104.21 / $104.21	Facility		$104.21	$104.21	$104.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $76.06 / $104.21	Professional		$76.06	$76.06	$104.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $80.08 / $135.34 / $348.83	Facility		$80.08	$135.34	$348.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $80.16 / $136.69 / $270.58	Professional		$80.16	$136.69	$270.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.82 / $97.58 / $107.33	Professional		$87.82	$97.58	$107.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $101.04 / $124.31 / $127.29	Facility		$101.04	$124.31	$127.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $114.56 / $127.29 / $133.65	Professional		$114.56	$127.29	$133.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.46 / $142.96 / $248.62	Facility		$111.46	$142.96	$248.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $121.16 / $124.31 / $124.31	Facility		$121.16	$124.31	$124.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $101.12 / $108.20 / $140.02	Professional		$101.12	$108.20	$140.02
United Facility/Professional Professional Modifier Low / Median / High Price $58.72 / $63.61 / $121.16	Professional		$58.72	$63.61	$121.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.84 / $46.84 / $76.45	Professional		$46.84	$46.84	$76.45