Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.93 / $426.60 / $445.39	Facility		$187.93	$426.60	$445.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.37 / $187.93 / $445.39	Professional		$121.37	$187.93	$445.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $253.22 / $522.46 / $1,167.33	Facility		$253.22	$522.46	$1,167.33
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $172.55 / $245.81 / $1,514.88	Professional		$172.55	$245.81	$1,514.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.85 / $140.85 / $140.85	Facility		$140.85	$140.85	$140.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.82 / $102.82 / $140.85	Professional		$102.82	$102.82	$140.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $136.94 / $274.73 / $623.42	Facility		$136.94	$274.73	$623.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $137.10 / $274.73 / $461.74	Professional		$137.10	$274.73	$461.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $221.70 / $243.87	Professional		$199.53	$221.70	$243.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $229.55 / $260.27 / $289.19	Facility		$229.55	$260.27	$289.19
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $229.74 / $289.19 / $289.19	Professional		$229.74	$289.19	$289.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $253.22 / $324.77 / $564.82	Facility		$253.22	$324.77	$564.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $275.25 / $282.41 / $282.41	Facility		$275.25	$282.41	$282.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $229.74 / $245.81 / $318.11	Professional		$229.74	$245.81	$318.11
United Facility/Professional Professional Modifier Low / Median / High Price $108.63 / $163.63 / $207.25	Professional		$108.63	$163.63	$207.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.43 / $87.43 / $132.08	Professional		$87.43	$87.43	$132.08