Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.01 / $142.69 / $306.54	Facility		$107.01	$142.69	$306.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.59 / $135.13 / $220.21	Professional		$99.59	$135.13	$220.21
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $442.00 / $442.00 / $442.00	Professional	25	$442.00	$442.00	$442.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.60 / $128.68 / $226.02	Professional		$101.60	$128.68	$226.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $59.04 / $543.76 / $629.74	Facility		$59.04	$543.76	$629.74
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $120.24 / $201.17 / $1,087.88	Professional		$120.24	$201.17	$1,087.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Facility		$50.00	$50.00	$50.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $151.00 / $328.51	Professional		$88.00	$151.00	$328.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $101.69 / $136.65 / $267.50	Facility		$101.69	$136.65	$267.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.32 / $133.38 / $241.15	Professional		$103.32	$133.38	$241.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.73 / $239.93 / $431.43	Professional		$47.73	$239.93	$431.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $157.58 / $248.52 / $306.19	Facility		$157.58	$248.52	$306.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $197.51 / $197.51 / $197.51	Facility		$197.51	$197.51	$197.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.52 / $291.57 / $381.15	Professional		$180.52	$291.57	$381.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $59.04 / $107.97 / $543.76	Facility		$59.04	$107.97	$543.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.24 / $161.50 / $219.46	Professional		$120.24	$161.50	$219.46
United Facility/Professional Professional Modifier Low / Median / High Price $110.30 / $182.28 / $387.39	Professional		$110.30	$182.28	$387.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.68 / $142.43 / $166.50	Professional		$131.68	$142.43	$166.50