Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.70 / $137.61 / $544.00	Facility		$107.70	$137.61	$544.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.70 / $143.77 / $268.30	Professional		$107.70	$143.77	$268.30
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $261.39 / $261.39 / $424.00	Professional	25	$261.39	$261.39	$424.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.84 / $152.44 / $301.89	Professional		$124.84	$152.44	$301.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $245.20 / $653.54 / $653.54	Facility		$245.20	$653.54	$653.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $180.18 / $341.13 / $1,090.50	Professional		$180.18	$341.13	$1,090.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $117.80 / $235.69 / $398.75	Facility		$117.80	$235.69	$398.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.32 / $224.68 / $395.09	Professional		$117.32	$224.68	$395.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.11 / $268.47 / $459.35	Professional		$46.11	$268.47	$459.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $312.89 / $333.66	Facility		$200.00	$312.89	$333.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $221.97 / $221.97 / $221.97	Facility		$221.97	$221.97	$221.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.84 / $307.80 / $430.40	Professional		$214.84	$307.80	$430.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $340.66 / $374.61 / $478.95	Facility		$340.66	$374.61	$478.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $183.29 / $273.66 / $392.47	Professional		$183.29	$273.66	$392.47
United Facility/Professional Professional Modifier Low / Median / High Price $152.77 / $261.52 / $467.41	Professional		$152.77	$261.52	$467.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $137.19 / $137.19 / $179.34	Professional		$137.19	$137.19	$179.34