Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.38 / $206.12 / $340.22	Facility		$149.38	$206.12	$340.22
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $39.43 / $145.47 / $376.96	Facility	25	$39.43	$145.47	$376.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.81 / $174.50 / $388.80	Professional		$108.81	$174.50	$388.80
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $111.26 / $199.38 / $498.59	Professional	25	$111.26	$199.38	$498.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.06 / $236.02 / $330.54	Professional		$153.06	$236.02	$330.54
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $154.53 / $223.55 / $335.87	Professional	25	$154.53	$223.55	$335.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $604.00 / $604.00	Facility		$70.00	$604.00	$604.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $180.91 / $320.27 / $1,041.60	Professional		$180.91	$320.27	$1,041.60
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $167.13 / $249.23 / $362.12	Professional	25	$167.13	$249.23	$362.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $148.00 / $217.61	Facility		$125.00	$148.00	$217.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.06 / $248.82 / $441.19	Professional		$127.06	$248.82	$441.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $120.81 / $247.84 / $383.95	Facility		$120.81	$247.84	$383.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.77 / $245.46 / $382.16	Professional		$120.77	$245.46	$382.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.14 / $260.29 / $459.35	Professional		$46.14	$260.29	$459.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $224.32 / $310.20 / $336.34	Facility		$224.32	$310.20	$336.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $221.97 / $221.97 / $221.97	Facility		$221.97	$221.97	$221.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.22 / $312.56 / $431.29	Professional		$214.22	$312.56	$431.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $183.00 / $274.72 / $389.80	Professional		$183.00	$274.72	$389.80
United Facility/Professional Facility Modifier Low / Median / High Price $188.95 / $188.95 / $188.95	Facility		$188.95	$188.95	$188.95
United Facility/Professional Professional Modifier Low / Median / High Price $157.97 / $245.64 / $465.07	Professional		$157.97	$245.64	$465.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $139.41 / $139.72 / $181.55	Professional		$139.41	$139.72	$181.55