Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.43 / $149.47 / $177.86	Professional		$80.43	$149.47	$177.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $352.16 / $1,022.25 / $10,000.00	Facility		$352.16	$1,022.25	$10,000.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $147.47 / $1,182.56 / $1,787.70	Professional		$147.47	$1,182.56	$1,787.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.87 / $87.87 / $87.87	Professional		$87.87	$87.87	$87.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $128.65 / $207.99 / $501.62	Facility		$128.65	$207.99	$501.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.85 / $210.52 / $408.17	Professional		$129.85	$210.52	$408.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Professional		$70.00	$70.00	$70.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $178.77 / $183.06 / $205.03	Facility		$178.77	$183.06	$205.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,000.00 / $10,000.00 / $10,000.00	Facility		$10,000.00	$10,000.00	$10,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $10,000.00 / $10,000.00 / $10,000.00	Professional		$10,000.00	$10,000.00	$10,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $84.44 / $91.33 / $174.24	Professional		$84.44	$91.33	$174.24