Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $256.26 / $432.98	Facility		$140.00	$256.26	$432.98
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $121.00 / $121.00 / $121.00	Facility	25	$121.00	$121.00	$121.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.09 / $168.96 / $361.33	Professional		$113.09	$168.96	$361.33
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $50.18 / $240.52 / $601.00	Professional	25	$50.18	$240.52	$601.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.54 / $235.20 / $322.32	Professional		$204.54	$235.20	$322.32
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $212.73 / $212.73 / $212.73	Professional	25	$212.73	$212.73	$212.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $269.20 / $374.61 / $716.59	Facility		$269.20	$374.61	$716.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $180.34 / $325.32 / $887.76	Professional		$180.34	$325.32	$887.76
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $126.79 / $190.03 / $306.52	Professional	25	$126.79	$190.03	$306.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.88 / $273.97 / $458.41	Professional		$142.88	$273.97	$458.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $118.72 / $172.94 / $326.05	Facility		$118.72	$172.94	$326.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.20 / $163.63 / $305.87	Professional		$109.20	$163.63	$305.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.81 / $291.11 / $512.39	Professional		$56.81	$291.11	$512.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $209.04 / $341.55 / $416.07	Facility		$209.04	$341.55	$416.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $269.20 / $273.61 / $273.61	Facility		$269.20	$273.61	$273.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.64 / $327.56 / $488.98	Professional		$200.64	$327.56	$488.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $242.92 / $374.61 / $716.59	Facility		$242.92	$374.61	$716.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $191.44 / $276.63 / $452.68	Professional		$191.44	$276.63	$452.68
United Facility/Professional Professional Modifier Low / Median / High Price $192.80 / $265.10 / $514.80	Professional		$192.80	$265.10	$514.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $135.34 / $171.72 / $227.52	Professional		$135.34	$171.72	$227.52