Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.84 / $115.29 / $349.86	Facility		$108.84	$115.29	$349.86
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $6.12 / $6.12 / $6.12	Facility	25	$6.12	$6.12	$6.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.55 / $129.83 / $226.54	Professional		$77.55	$129.83	$226.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $78.18 / $143.06 / $207.12	Professional	25	$78.18	$143.06	$207.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.49 / $237.71 / $262.26	Professional		$128.49	$237.71	$262.26
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $111.56 / $111.56 / $122.89	Professional	25	$111.56	$111.56	$122.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $213.38 / $345.99 / $667.49	Facility		$213.38	$345.99	$667.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $150.41 / $286.41 / $1,105.73	Professional		$150.41	$286.41	$1,105.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $116.36	Professional		$116.36	$116.36	$116.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $104.50 / $222.23 / $385.47	Facility		$104.50	$222.23	$385.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.88 / $190.90 / $301.37	Professional		$103.88	$190.90	$301.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $214.66 / $370.30	Professional		$36.88	$214.66	$370.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $160.22 / $221.68 / $261.97	Facility		$160.22	$221.68	$261.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.11 / $248.99 / $264.88	Facility		$208.11	$248.99	$264.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $162.69 / $195.23 / $234.58	Facility		$162.69	$195.23	$234.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $176.95 / $250.36 / $337.38	Professional		$176.95	$250.36	$337.38
United Facility/Professional Professional Modifier Low / Median / High Price $124.12 / $183.28 / $364.81	Professional		$124.12	$183.28	$364.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.94 / $107.94 / $141.76	Professional		$107.94	$107.94	$141.76