Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.67 / $212.63 / $222.00	Facility		$93.67	$212.63	$222.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $93.67 / $222.00	Professional		$72.06	$93.67	$222.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $126.22 / $288.29 / $730.36	Facility		$126.22	$288.29	$730.36
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $105.22 / $140.28 / $879.36	Professional		$105.22	$140.28	$879.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.07 / $90.07 / $90.07	Facility		$90.07	$90.07	$90.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.75 / $65.75 / $90.07	Professional		$65.75	$65.75	$90.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $90.54 / $153.03 / $394.97	Facility		$90.54	$153.03	$394.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.64 / $154.41 / $306.17	Professional		$90.64	$154.41	$306.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $99.45 / $110.50 / $121.55	Professional		$99.45	$110.50	$121.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $114.41 / $140.76 / $144.13	Facility		$114.41	$140.76	$144.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $114.41 / $144.13 / $158.55	Professional		$114.41	$144.13	$158.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $126.22 / $161.87 / $281.52	Facility		$126.22	$161.87	$281.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $137.19 / $140.76 / $140.76	Facility		$137.19	$140.76	$140.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.51 / $122.52 / $158.55	Professional		$114.51	$122.52	$158.55
United Facility/Professional Professional Modifier Low / Median / High Price $71.91 / $107.87 / $137.19	Professional		$71.91	$107.87	$137.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.31 / $33.31 / $122.52	Professional		$33.31	$33.31	$122.52