Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.45 / $112.25 / $117.20	Facility		$49.45	$112.25	$117.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.53 / $49.45 / $117.20	Professional		$42.53	$49.45	$117.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $64.16 / $152.38 / $349.60	Facility		$64.16	$152.38	$349.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $52.18 / $63.74 / $378.23	Professional		$52.18	$63.74	$378.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.91 / $41.91 / $41.91	Facility		$41.91	$41.91	$41.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.59 / $30.59 / $41.91	Professional		$30.59	$30.59	$41.91
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $42.31 / $73.27 / $192.18	Facility		$42.31	$73.27	$192.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.36 / $74.06 / $142.33	Professional		$42.36	$74.06	$142.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $73.27 / $73.27	Professional		$60.00	$73.27	$73.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $58.16 / $71.55 / $75.95	Facility		$58.16	$71.55	$75.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $65.94 / $73.27 / $75.95	Professional		$65.94	$73.27	$75.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.16 / $82.28 / $143.10	Facility		$64.16	$82.28	$143.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.82 / $60.82 / $71.55	Professional		$60.82	$60.82	$71.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $71.55 / $71.55	Facility		$69.73	$71.55	$71.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $58.21 / $62.28 / $80.59	Professional		$58.21	$62.28	$80.59
United Facility/Professional Professional Modifier Low / Median / High Price $30.94 / $36.09 / $63.84	Professional		$30.94	$36.09	$63.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.61 / $15.61 / $62.28	Professional		$15.61	$15.61	$62.28