Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.23 / $145.63 / $272.89	Facility		$109.23	$145.63	$272.89
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $112.64 / $261.25 / $444.86	Facility	25	$112.64	$261.25	$444.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.08 / $119.96 / $267.62	Professional		$63.08	$119.96	$267.62
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $53.78 / $135.26 / $353.00	Professional	25	$53.78	$135.26	$353.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $287.60	Professional	50	$94.50	$94.50	$287.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.29 / $171.43 / $253.98	Professional		$114.29	$171.43	$253.98
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $117.95 / $171.44 / $258.91	Professional	25	$117.95	$171.44	$258.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $438.98 / $438.98	Facility		$50.00	$438.98	$438.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $126.44 / $238.39 / $801.06	Professional		$126.44	$238.39	$801.06
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $121.47 / $182.18 / $277.72	Professional	25	$121.47	$182.18	$277.72
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $139.86 / $179.50 / $203.21	Professional	50	$139.86	$179.50	$203.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $148.00 / $166.95	Facility		$125.00	$148.00	$166.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.23 / $173.21 / $334.75	Professional		$80.23	$173.21	$334.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.48 / $155.56 / $260.69	Facility		$74.48	$155.56	$260.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.48 / $155.29 / $265.82	Professional		$74.48	$155.29	$265.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.91 / $209.14 / $369.60	Professional		$36.91	$209.14	$369.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $145.91 / $211.75 / $257.95	Facility		$145.91	$211.75	$257.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.88 / $169.88 / $169.88	Facility		$169.88	$169.88	$169.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $156.27 / $233.43 / $331.10	Professional		$156.27	$233.43	$331.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $131.47 / $199.99 / $296.66	Professional		$131.47	$199.99	$296.66
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $157.19 / $302.39	Professional		$102.33	$157.19	$302.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.67 / $106.84 / $139.94	Professional		$101.67	$106.84	$139.94