Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.31 / $113.90 / $205.21	Professional		$71.31	$113.90	$205.21
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $76.45 / $145.82 / $390.60	Professional	25	$76.45	$145.82	$390.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.88 / $198.38 / $257.13	Professional		$146.88	$198.38	$257.13
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $123.99 / $123.99 / $123.99	Professional	25	$123.99	$123.99	$123.99
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $168.06 / $168.06 / $520.08	Facility		$168.06	$168.06	$520.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $80.84 / $194.81 / $1,066.50	Professional		$80.84	$194.81	$1,066.50
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $127.05 / $127.05 / $127.05	Professional	50	$127.05	$127.05	$127.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.09 / $150.94 / $324.69	Professional		$77.09	$150.94	$324.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $95.91 / $152.35 / $308.10	Facility		$95.91	$152.35	$308.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.50 / $156.76 / $299.95	Professional		$96.50	$156.76	$299.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.11 / $158.36 / $277.09	Professional		$27.11	$158.36	$277.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $233.83 / $252.59	Facility		$95.00	$233.83	$252.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $168.06 / $168.06 / $168.06	Facility		$168.06	$168.06	$168.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.25 / $194.81 / $324.45	Professional		$117.25	$194.81	$324.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $80.84 / $128.46 / $171.94	Professional		$80.84	$128.46	$171.94
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $188.15 / $341.90	Professional		$134.90	$188.15	$341.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $75.00 / $130.00	Professional		$48.00	$75.00	$130.00