Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.95 / $130.82 / $136.05	Facility		$71.95	$130.82	$136.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $71.30 / $81.76	Professional		$65.41	$71.30	$81.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $32.50 / $65.41 / $288.80	Facility		$32.50	$65.41	$288.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $68.03 / $379.80	Professional		$65.41	$68.03	$379.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.70 / $61.70 / $130.82	Facility		$61.70	$61.70	$130.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.40 / $65.40 / $80.20	Professional		$65.40	$65.40	$80.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $36.07 / $65.41 / $108.69	Facility		$36.07	$65.41	$108.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.37 / $65.41 / $108.18	Professional		$42.37	$65.41	$108.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $65.41 / $75.00	Professional		$30.00	$65.41	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $44.16 / $65.40 / $123.62	Facility		$44.16	$65.40	$123.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.83 / $42.81 / $78.81	Facility		$31.83	$42.81	$78.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.95 / $77.13 / $120.19	Professional		$70.95	$77.13	$120.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $39.54 / $65.41 / $65.41	Facility		$39.54	$65.41	$65.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $62.14 / $65.41 / $65.41	Professional		$62.14	$65.41	$65.41
United Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $65.41 / $78.48	Professional		$65.41	$65.41	$78.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $65.41 / $65.41	Professional		$65.41	$65.41	$65.41