Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $236.07 / $535.88 / $559.49	Facility		$236.07	$535.88	$559.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.75 / $236.07 / $559.49	Professional		$160.75	$236.07	$559.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $318.08 / $691.76 / $1,670.71	Facility		$318.08	$691.76	$1,670.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $240.68 / $308.77 / $1,806.48	Professional		$240.68	$308.77	$1,806.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $265.56 / $265.56 / $265.56	Facility		$265.56	$265.56	$265.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.86 / $193.86 / $265.56	Professional		$193.86	$193.86	$265.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $193.83 / $363.26 / $881.25	Facility		$193.83	$363.26	$881.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.04 / $354.91 / $653.72	Professional		$194.04	$354.91	$653.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $250.64 / $278.49 / $306.33	Professional		$250.64	$278.49	$306.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $288.36 / $326.93 / $363.26	Facility		$288.36	$326.93	$363.26
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $321.50 / $353.65 / $363.26	Professional		$321.50	$353.65	$363.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $318.08 / $407.96 / $709.50	Facility		$318.08	$407.96	$709.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $345.76 / $354.75 / $354.75	Facility		$345.76	$354.75	$354.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $288.58 / $308.77 / $399.59	Professional		$288.58	$308.77	$399.59
United Facility/Professional Professional Modifier Low / Median / High Price $153.60 / $230.40 / $293.04	Professional		$153.60	$230.40	$293.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.26 / $83.26 / $308.77	Professional		$83.26	$83.26	$308.77