Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.35 / $136.63 / $230.25	Facility		$94.35	$136.63	$230.25
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $108.00 / $307.00 / $410.53	Facility	25	$108.00	$307.00	$410.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.48 / $113.20 / $255.15	Professional		$66.48	$113.20	$255.15
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $64.48 / $127.31 / $306.85	Professional	25	$64.48	$127.31	$306.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.09 / $158.40 / $220.86	Professional		$108.09	$158.40	$220.86
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $103.64 / $150.18 / $225.57	Professional	25	$103.64	$150.18	$225.57
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $370.89 / $370.89	Facility		$70.00	$370.89	$370.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $111.75 / $205.86 / $699.27	Professional		$111.75	$205.86	$699.27
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $102.62 / $154.97 / $241.66	Professional	25	$102.62	$154.97	$241.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $146.68 / $148.00	Facility		$125.00	$146.68	$148.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.27 / $156.38 / $294.81	Professional		$75.27	$156.38	$294.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $77.93 / $152.52 / $252.38	Facility		$77.93	$152.52	$252.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.91 / $152.27 / $256.54	Professional		$77.91	$152.27	$256.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.91 / $209.14 / $369.47	Professional		$36.91	$209.14	$369.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $146.41 / $203.01 / $224.45	Facility		$146.41	$203.01	$224.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $149.04 / $149.04 / $149.04	Facility		$149.04	$149.04	$149.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.66 / $203.11 / $288.70	Professional		$135.66	$203.11	$288.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $121.08 / $177.30 / $259.29	Professional		$121.08	$177.30	$259.29
United Facility/Professional Professional Modifier Low / Median / High Price $93.93 / $157.19 / $316.33	Professional		$93.93	$157.19	$316.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.62 / $93.04 / $121.93	Professional		$85.62	$93.04	$121.93