Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $185.55 / $325.00 / $439.75	Facility		$185.55	$325.00	$439.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.46 / $185.55 / $439.75	Professional		$147.46	$185.55	$439.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $250.01 / $623.75 / $1,523.57	Facility		$250.01	$623.75	$1,523.57
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $208.43 / $278.45 / $1,837.84	Professional		$208.43	$278.45	$1,837.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.64 / $177.64 / $177.64	Facility		$177.64	$177.64	$177.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.68 / $129.68 / $177.64	Professional		$129.68	$129.68	$177.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $175.17 / $298.70 / $782.45	Facility		$175.17	$298.70	$782.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $175.36 / $298.70 / $590.83	Professional		$175.36	$298.70	$590.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $197.00 / $218.89 / $240.77	Professional		$197.00	$218.89	$240.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $226.65 / $278.83 / $294.91	Facility		$226.65	$278.83	$294.91
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $256.97 / $285.52 / $294.91	Professional		$256.97	$285.52	$294.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $250.01 / $320.64 / $557.66	Facility		$250.01	$320.64	$557.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $271.76 / $278.83 / $278.83	Facility		$271.76	$278.83	$278.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $226.83 / $242.69 / $314.07	Professional		$226.83	$242.69	$314.07
United Facility/Professional Professional Modifier Low / Median / High Price $138.91 / $208.39 / $265.04	Professional		$138.91	$208.39	$265.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.86 / $72.86 / $242.69	Professional		$72.86	$72.86	$242.69