Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.52 / $132.84 / $138.69	Facility		$58.52	$132.84	$138.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.34 / $53.40 / $98.59	Professional		$41.34	$53.40	$98.59
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $75.93 / $180.41 / $413.81	Facility		$75.93	$180.41	$413.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $61.76 / $75.45 / $447.50	Professional		$61.76	$75.45	$447.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.61 / $49.61 / $49.61	Facility		$49.61	$49.61	$49.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.52 / $36.22 / $93.20	Professional		$9.52	$36.22	$93.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $24.19 / $86.72 / $227.81	Facility		$24.19	$86.72	$227.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.47 / $86.72 / $168.81	Professional		$24.47	$86.72	$168.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $86.72	Professional		$60.00	$60.00	$86.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.84 / $84.69 / $89.86	Facility		$68.84	$84.69	$89.86
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $78.05 / $86.72 / $89.86	Professional		$78.05	$86.72	$89.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.93 / $97.39 / $169.38	Facility		$75.93	$97.39	$169.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.98 / $71.98 / $84.69	Professional		$71.98	$71.98	$84.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $82.54 / $84.69 / $84.69	Facility		$82.54	$84.69	$84.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $68.90 / $73.70 / $95.39	Professional		$68.90	$73.70	$95.39
United Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $39.60 / $75.56	Professional		$36.61	$39.60	$75.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.59 / $27.59 / $73.70	Professional		$27.59	$27.59	$73.70