Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.57 / $767.68 / $1,627.58	Facility		$60.57	$767.68	$1,627.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.32 / $60.57 / $187.94	Professional		$49.32	$60.57	$187.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $78.59 / $291.25 / $428.17	Facility		$78.59	$291.25	$428.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $65.04 / $78.54 / $657.38	Professional		$65.04	$78.54	$657.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.54 / $61.54 / $61.54	Facility		$61.54	$61.54	$61.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.92 / $44.92 / $113.47	Professional		$44.92	$44.92	$113.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.66 / $102.33 / $303.72	Facility		$57.66	$102.33	$303.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $98.67 / $191.88	Professional		$57.66	$98.67	$191.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.92 / $68.80 / $75.68	Professional		$61.92	$68.80	$75.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $71.25 / $87.65 / $92.92	Facility		$71.25	$87.65	$92.92
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $80.78 / $89.75 / $92.92	Professional		$80.78	$89.75	$92.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.59 / $100.80 / $175.30	Facility		$78.59	$100.80	$175.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.50 / $74.50 / $87.65	Professional		$74.50	$74.50	$87.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $85.43 / $87.65 / $87.65	Facility		$85.43	$87.65	$87.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $71.30 / $76.29 / $98.73	Professional		$71.30	$76.29	$98.73
United Facility/Professional Professional Modifier Low / Median / High Price $37.89 / $41.05 / $78.18	Professional		$37.89	$41.05	$78.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $49.10 / $78.06 / $78.06	Professional		$49.10	$78.06	$78.06