Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $96.81 / $216.00	Facility		$79.43	$96.81	$216.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $93.06 / $93.06 / $93.06	Facility	25	$93.06	$93.06	$93.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.32 / $86.48 / $236.70	Professional		$62.32	$86.48	$236.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.62 / $136.78 / $158.16	Professional		$80.62	$136.78	$158.16
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $94.22 / $151.93 / $366.35	Facility		$94.22	$151.93	$366.35
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $84.86 / $158.85 / $476.33	Professional		$84.86	$158.85	$476.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.04 / $142.61 / $228.34	Professional		$72.04	$142.61	$228.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $64.17 / $127.60 / $181.16	Facility		$64.17	$127.60	$181.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $137.22 / $182.26	Professional		$64.48	$137.22	$182.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.08 / $157.43 / $283.92	Professional		$29.08	$157.43	$283.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.96 / $137.35 / $161.47	Facility		$99.96	$137.35	$161.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.22 / $94.22 / $104.47	Facility		$94.22	$94.22	$104.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.37 / $178.84 / $218.61	Professional		$113.37	$178.84	$218.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.26 / $148.09 / $198.78	Professional		$95.26	$148.09	$198.78
United Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $100.93 / $212.23	Professional		$80.33	$100.93	$212.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.81 / $66.81 / $85.49	Professional		$66.81	$66.81	$85.49