Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $400.96 / $910.18 / $950.28	Facility		$400.96	$910.18	$950.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.74 / $400.96 / $950.28	Professional		$250.74	$400.96	$950.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $540.27 / $1,114.70 / $2,561.73	Facility		$540.27	$1,114.70	$2,561.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $351.04 / $524.45 / $3,309.77	Professional		$351.04	$524.45	$3,309.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $344.22 / $344.22 / $344.22	Facility		$344.22	$344.22	$344.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.28 / $251.28 / $344.22	Professional		$251.28	$251.28	$344.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $315.31 / $601.58 / $1,436.25	Facility		$315.31	$601.58	$1,436.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $315.66 / $591.16 / $1,064.16	Professional		$315.66	$591.16	$1,064.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $425.69 / $472.99 / $520.28	Professional		$425.69	$472.99	$520.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $489.72 / $551.63 / $617.00	Facility		$489.72	$551.63	$617.00
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $489.76 / $617.00 / $629.34	Professional		$489.76	$617.00	$629.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $540.27 / $692.92 / $1,205.08	Facility		$540.27	$692.92	$1,205.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $587.27 / $602.54 / $602.54	Facility		$587.27	$602.54	$602.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $490.14 / $524.45 / $678.70	Professional		$490.14	$524.45	$678.70
United Facility/Professional Professional Modifier Low / Median / High Price $250.18 / $375.27 / $477.31	Professional		$250.18	$375.27	$477.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.57 / $218.57 / $304.95	Professional		$218.57	$218.57	$304.95