Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.28 / $512.41 / $2,075.83	Facility		$129.28	$512.41	$2,075.83
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $553.23 / $922.00 / $5,242.72	Facility	25	$553.23	$922.00	$5,242.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.00 / $132.00 / $280.42	Professional		$99.00	$132.00	$280.42
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $95.58 / $247.56 / $491.29	Professional	25	$95.58	$247.56	$491.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.96 / $227.44 / $432.11	Professional		$115.96	$227.44	$432.11
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $116.60 / $185.54 / $381.11	Professional	25	$116.60	$185.54	$381.11
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $544.99 / $544.99 / $544.99	Facility		$544.99	$544.99	$544.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $163.05 / $249.82 / $748.12	Professional		$163.05	$249.82	$748.12
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $226.46 / $226.46 / $226.46	Professional	25	$226.46	$226.46	$226.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,442.00 / $3,442.00 / $3,442.00	Facility		$3,442.00	$3,442.00	$3,442.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.15 / $234.84 / $362.94	Professional		$137.15	$234.84	$362.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $106.95 / $231.99 / $1,038.32	Facility		$106.95	$231.99	$1,038.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.85 / $189.75 / $284.25	Professional		$103.85	$189.75	$284.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.26 / $210.68 / $389.15	Professional		$38.26	$210.68	$389.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $166.60 / $226.46 / $240.53	Facility		$166.60	$226.46	$240.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.13 / $266.42 / $325.64	Professional		$181.13	$266.42	$325.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $163.05 / $225.18 / $302.00	Professional		$163.05	$225.18	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $131.82 / $202.63 / $345.66	Professional		$131.82	$202.63	$345.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.39 / $99.39 / $122.94	Professional		$99.39	$99.39	$122.94