Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.24 / $136.97 / $184.32	Facility		$104.24	$136.97	$184.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $91.05 / $134.40	Professional		$66.06	$91.05	$134.40
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $120.00 / $120.00 / $120.00	Professional	25	$120.00	$120.00	$120.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.94 / $83.73 / $186.76	Professional		$69.94	$83.73	$186.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $117.78 / $383.01 / $383.01	Facility		$117.78	$383.01	$383.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $77.61 / $125.97 / $666.98	Professional		$77.61	$125.97	$666.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.80 / $108.60 / $241.07	Professional		$55.80	$108.60	$241.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $62.91 / $86.36 / $162.51	Facility		$62.91	$86.36	$162.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.23 / $87.42 / $153.26	Professional		$65.23	$87.42	$153.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $144.36 / $258.88	Professional		$28.91	$144.36	$258.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $102.91 / $156.11 / $182.91	Facility		$102.91	$156.11	$182.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.78 / $117.78 / $117.78	Facility		$117.78	$117.78	$117.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.84 / $176.53 / $228.48	Professional		$107.84	$176.53	$228.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $78.59 / $107.18 / $173.29	Professional		$78.59	$107.18	$173.29
United Facility/Professional Professional Modifier Low / Median / High Price $78.64 / $120.75 / $245.76	Professional		$78.64	$120.75	$245.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $78.95 / $86.98 / $100.01	Professional		$78.95	$86.98	$100.01