Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.22 / $26.08 / $38.18	Facility		$20.22	$26.08	$38.18
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $85.47 / $85.47 / $85.47	Facility	25	$85.47	$85.47	$85.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.18 / $15.79 / $35.24	Professional		$11.18	$15.79	$35.24
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $13.96 / $27.27 / $51.88	Professional	25	$13.96	$27.27	$51.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.03 / $21.02 / $26.43	Professional		$14.03	$21.02	$26.43
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $16.18 / $22.50 / $28.12	Professional	25	$16.18	$22.50	$28.12
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $12.61 / $80.00 / $147.47	Facility		$12.61	$80.00	$147.47
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $16.03 / $26.95 / $199.96	Professional		$16.03	$26.95	$199.96
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $14.66 / $22.14 / $31.74	Professional	25	$14.66	$22.14	$31.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.30 / $24.20 / $39.96	Professional		$13.30	$24.20	$39.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $12.38 / $24.84 / $34.68	Facility		$12.38	$24.84	$34.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $11.57 / $22.40 / $33.72	Professional		$11.57	$22.40	$33.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $190.00 / $477.35	Professional		$60.00	$190.00	$477.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $19.60 / $27.20 / $29.48	Facility		$19.60	$27.20	$29.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $20.39 / $20.39 / $20.39	Facility		$20.39	$20.39	$20.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.98 / $27.77 / $39.25	Professional		$18.98	$27.77	$39.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $73.95 / $81.31 / $112.87	Facility		$73.95	$81.31	$112.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $17.41 / $24.46 / $34.50	Professional		$17.41	$24.46	$34.50
United Facility/Professional Professional Modifier Low / Median / High Price $15.68 / $24.08 / $42.57	Professional		$15.68	$24.08	$42.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $11.87 / $12.20 / $15.36	Professional		$11.87	$12.20	$15.36