Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.30 / $137.30 / $220.22	Facility		$137.30	$137.30	$220.22
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $121.00 / $121.00 / $261.00	Facility	25	$121.00	$121.00	$261.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.37 / $170.45 / $321.37	Professional		$136.37	$170.45	$321.37
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $115.53 / $256.83 / $463.05	Professional	25	$115.53	$256.83	$463.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $140.94 / $196.84 / $196.84	Professional		$140.94	$196.84	$196.84
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $156.18 / $156.18 / $156.18	Professional	25	$156.18	$156.18	$156.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $271.44 / $439.22 / $842.92	Facility		$271.44	$439.22	$842.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $192.42 / $377.65 / $1,401.98	Professional		$192.42	$377.65	$1,401.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $147.60	Professional		$147.60	$147.60	$147.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $155.82 / $335.02 / $498.07	Facility		$155.82	$335.02	$498.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.25 / $280.60 / $425.02	Professional		$154.25	$280.60	$425.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.14 / $263.90 / $458.19	Professional		$46.14	$263.90	$458.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $236.18 / $324.27 / $332.99	Facility		$236.18	$324.27	$332.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $264.19 / $317.91 / $338.20	Facility		$264.19	$317.91	$338.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $206.80 / $248.16 / $345.74	Facility		$206.80	$248.16	$345.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $226.38 / $321.44 / $427.24	Professional		$226.38	$321.44	$427.24
United Facility/Professional Professional Modifier Low / Median / High Price $172.87 / $268.58 / $474.07	Professional		$172.87	$268.58	$474.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $136.93 / $136.93 / $178.95	Professional		$136.93	$136.93	$178.95