Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.71 / $101.49 / $105.96	Facility		$44.71	$101.49	$105.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.57 / $44.71 / $105.96	Professional		$38.57	$44.71	$105.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $58.01 / $165.26 / $362.42	Facility		$58.01	$165.26	$362.42
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $48.36 / $58.01 / $492.89	Professional		$48.36	$58.01	$492.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.83 / $55.83 / $55.83	Facility		$55.83	$55.83	$55.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.76 / $40.76 / $55.83	Professional		$40.76	$40.76	$55.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $41.86 / $70.73 / $181.55	Facility		$41.86	$70.73	$181.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.90 / $70.87 / $140.66	Professional		$41.90	$70.87	$140.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $66.25 / $66.25	Professional		$60.00	$66.25	$66.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $52.59 / $64.69 / $68.88	Facility		$52.59	$64.69	$68.88
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $66.25 / $66.25 / $68.88	Professional		$66.25	$66.25	$68.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.01 / $74.39 / $129.38	Facility		$58.01	$74.39	$129.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.99 / $54.99 / $54.99	Professional		$54.99	$54.99	$54.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $63.06 / $64.69 / $64.69	Facility		$63.06	$64.69	$64.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $52.63 / $56.31 / $72.88	Professional		$52.63	$56.31	$72.88
United Facility/Professional Professional Modifier Low / Median / High Price $30.56 / $35.65 / $63.06	Professional		$30.56	$35.65	$63.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.64 / $56.31 / $56.31	Professional		$39.64	$56.31	$56.31