Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.06 / $276.74 / $543.12	Facility		$203.06	$276.74	$543.12
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $666.42 / $666.42 / $1,149.00	Facility	25	$666.42	$666.42	$1,149.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.05 / $224.74 / $517.87	Professional		$143.05	$224.74	$517.87
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $144.47 / $280.70 / $700.06	Professional	25	$144.47	$280.70	$700.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.04 / $327.06 / $442.41	Professional		$218.04	$327.06	$442.41
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $216.28 / $304.33 / $442.41	Professional	25	$216.28	$304.33	$442.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $822.00 / $822.00	Facility		$70.00	$822.00	$822.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $234.09 / $424.42 / $1,377.15	Professional		$234.09	$424.42	$1,377.15
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $227.46 / $338.42 / $477.54	Professional	25	$227.46	$338.42	$477.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $148.00 / $287.20	Facility		$125.00	$148.00	$287.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.85 / $336.06 / $597.36	Professional		$172.85	$336.06	$597.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $157.19 / $322.99 / $492.16	Facility		$157.19	$322.99	$492.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $157.19 / $310.33 / $493.06	Professional		$157.19	$310.33	$493.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.53 / $364.61 / $645.08	Professional		$64.53	$364.61	$645.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $277.24 / $390.61 / $443.54	Facility		$277.24	$390.61	$443.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $293.54 / $293.54 / $293.54	Facility		$293.54	$293.54	$293.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $286.98 / $423.51 / $569.44	Professional		$286.98	$423.51	$569.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $245.49 / $368.01 / $514.04	Professional		$245.49	$368.01	$514.04
United Facility/Professional Professional Modifier Low / Median / High Price $218.01 / $335.25 / $661.44	Professional		$218.01	$335.25	$661.44
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $80.00	Professional	25	$80.00	$80.00	$80.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $184.14 / $190.21 / $239.14	Professional		$184.14	$190.21	$239.14