Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.59 / $395.23 / $612.09	Facility		$156.59	$395.23	$612.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.01 / $236.33 / $465.53	Professional		$158.01	$236.33	$465.53
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $210.64 / $351.57 / $823.00	Professional	25	$210.64	$351.57	$823.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $232.02 / $432.14 / $436.68	Professional		$232.02	$432.14	$436.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $286.14 / $386.63 / $853.77	Facility		$286.14	$386.63	$853.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $249.04 / $444.57 / $1,202.95	Professional		$249.04	$444.57	$1,202.95
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $172.31 / $257.55 / $415.43	Professional	25	$172.31	$257.55	$415.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.56 / $384.91 / $622.66	Professional		$201.56	$384.91	$622.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $168.44 / $247.25 / $464.50	Facility		$168.44	$247.25	$464.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.87 / $234.99 / $425.71	Professional		$156.87	$234.99	$425.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.33 / $393.98 / $686.85	Professional		$75.33	$393.98	$686.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $277.20 / $460.29 / $562.79	Facility		$277.20	$460.29	$562.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $364.14 / $368.74 / $368.74	Facility		$364.14	$368.74	$368.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $271.68 / $445.67 / $661.42	Professional		$271.68	$445.67	$661.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $273.35 / $374.61 / $716.59	Facility		$273.35	$374.61	$716.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $259.23 / $372.81 / $613.29	Professional		$259.23	$372.81	$613.29
United Facility/Professional Professional Modifier Low / Median / High Price $282.73 / $391.60 / $779.94	Professional		$282.73	$391.60	$779.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $183.85 / $232.72 / $308.12	Professional		$183.85	$232.72	$308.12