Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.07 / $89.73 / $189.88	Facility		$61.07	$89.73	$189.88
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $47.01 / $167.04 / $384.30	Facility	25	$47.01	$167.04	$384.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.84 / $76.39 / $150.91	Professional		$42.84	$76.39	$150.91
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $56.00 / $93.25 / $205.25	Professional	25	$56.00	$93.25	$205.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.05 / $96.03 / $142.26	Professional		$70.05	$96.03	$142.26
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $60.46 / $113.81 / $146.30	Professional	25	$60.46	$113.81	$146.30
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $211.96 / $211.96	Facility		$70.00	$211.96	$211.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $68.27 / $127.90 / $456.37	Professional		$68.27	$127.90	$456.37
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $58.64 / $90.48 / $156.54	Professional	25	$58.64	$90.48	$156.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.71 / $125.00 / $148.00	Facility		$94.71	$125.00	$148.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.74 / $99.12 / $192.01	Professional		$51.74	$99.12	$192.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $51.80 / $101.43 / $169.30	Facility		$51.80	$101.43	$169.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.24 / $101.43 / $175.13	Professional		$51.24	$101.43	$175.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.45 / $104.57 / $185.15	Professional		$18.45	$104.57	$185.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.81 / $139.36 / $145.38	Facility		$95.81	$139.36	$145.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $96.94 / $96.94 / $96.94	Facility		$96.94	$96.94	$96.94
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.63 / $121.88 / $187.57	Professional		$78.63	$121.88	$187.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $70.15 / $107.96 / $169.53	Professional		$70.15	$107.96	$169.53
United Facility/Professional Professional Modifier Low / Median / High Price $77.03 / $113.03 / $207.59	Professional		$77.03	$113.03	$207.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $49.09 / $59.63 / $79.08	Professional		$49.09	$59.63	$79.08