Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.10 / $157.02 / $247.76	Facility		$56.10	$157.02	$247.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $90.17 / $207.16	Professional		$56.10	$90.17	$207.16
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $145.34 / $145.34 / $145.34	Professional	25	$145.34	$145.34	$145.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.04 / $139.04 / $139.04	Professional		$139.04	$139.04	$139.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $186.39 / $420.62 / $864.29	Facility		$186.39	$420.62	$864.29
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $116.18 / $210.11 / $569.78	Professional		$116.18	$210.11	$569.78
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $82.18 / $124.34 / $200.57	Professional	25	$82.18	$124.34	$200.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.79 / $168.48 / $294.95	Professional		$67.79	$168.48	$294.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $45.88 / $83.85 / $180.86	Facility		$45.88	$83.85	$180.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.30 / $82.60 / $164.71	Professional		$46.30	$82.60	$164.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.81 / $192.30 / $341.59	Professional		$37.81	$192.30	$341.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $98.49 / $194.62 / $270.01	Facility		$98.49	$194.62	$270.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.70 / $175.76 / $175.76	Facility		$174.70	$175.76	$175.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.07 / $212.15 / $311.92	Professional		$126.07	$212.15	$311.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $324.48 / $451.57 / $864.29	Facility		$324.48	$451.57	$864.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $122.74 / $177.70 / $278.89	Professional		$122.74	$177.70	$278.89
United Facility/Professional Professional Modifier Low / Median / High Price $97.28 / $145.91 / $358.31	Professional		$97.28	$145.91	$358.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $112.36 / $148.71	Professional		$87.56	$112.36	$148.71