Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.48 / $148.69 / $176.85	Facility		$111.48	$148.69	$176.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $111.48 / $174.95	Professional		$72.31	$111.48	$174.95
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $405.60 / $405.60 / $405.60	Professional	25	$405.60	$405.60	$405.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.26 / $230.52 / $246.61	Professional		$115.26	$230.52	$246.61
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $194.79 / $463.23 / $463.23	Facility		$194.79	$463.23	$463.23
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $112.70 / $215.97 / $635.76	Professional		$112.70	$215.97	$635.76
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $116.86 / $176.02 / $302.97	Professional	25	$116.86	$176.02	$302.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.08 / $193.42 / $351.26	Professional		$96.08	$193.42	$351.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $71.05 / $117.74 / $226.64	Facility		$71.05	$117.74	$226.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.02 / $117.74 / $199.87	Professional		$71.02	$117.74	$199.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.53 / $192.72 / $347.01	Professional		$38.53	$192.72	$347.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.79 / $259.39 / $281.39	Facility		$162.79	$259.39	$281.39
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.79 / $194.79 / $194.79	Facility		$194.79	$194.79	$194.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.57 / $237.20 / $363.05	Professional		$153.57	$237.20	$363.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $354.42 / $354.42 / $543.76	Facility		$354.42	$354.42	$543.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $136.94 / $196.94 / $297.14	Professional		$136.94	$196.94	$297.14
United Facility/Professional Professional Modifier Low / Median / High Price $146.78 / $232.92 / $399.96	Professional		$146.78	$232.92	$399.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.60 / $114.02 / $149.46	Professional		$99.60	$114.02	$149.46