Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.97 / $144.40 / $207.22	Facility		$89.97	$144.40	$207.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.13 / $84.04 / $184.87	Professional		$58.13	$84.04	$184.87
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $69.52 / $87.39 / $266.29	Professional	25	$69.52	$87.39	$266.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.62 / $116.78 / $145.44	Professional		$78.62	$116.78	$145.44
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.50 / $135.03 / $157.24	Professional	25	$67.50	$135.03	$157.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $140.88 / $339.11 / $339.11	Facility		$140.88	$339.11	$339.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $99.05 / $168.88 / $525.69	Professional		$99.05	$168.88	$525.69
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $93.82 / $129.26 / $177.46	Professional	25	$93.82	$129.26	$177.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.71 / $154.11 / $246.67	Professional		$83.71	$154.11	$246.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.09 / $146.36 / $209.43	Facility		$74.09	$146.36	$209.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.47 / $137.41 / $205.80	Professional		$73.47	$137.41	$205.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.52 / $160.18 / $274.75	Professional		$27.52	$160.18	$274.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $111.92 / $155.91 / $164.82	Facility		$111.92	$155.91	$164.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.89 / $111.89 / $111.89	Facility		$111.89	$111.89	$111.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.82 / $175.66 / $214.56	Professional		$108.82	$175.66	$214.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $229.71 / $252.61 / $324.48	Facility		$229.71	$252.61	$324.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $103.05 / $147.65 / $203.35	Professional		$103.05	$147.65	$203.35
United Facility/Professional Professional Modifier Low / Median / High Price $87.41 / $133.94 / $236.54	Professional		$87.41	$133.94	$236.54
United Facility/Professional Professional Modifier 25 Low / Median / High Price $98.97 / $99.10 / $103.13	Professional	25	$98.97	$99.10	$103.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.91 / $78.62 / $87.30	Professional		$67.91	$78.62	$87.30