Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.31 / $98.72 / $130.08	Facility	26	$55.31	$98.72	$130.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.84 / $105.49 / $241.30	Professional		$80.84	$105.49	$241.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $55.31 / $119.03	Professional	26	$40.29	$55.31	$119.03
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $61.16 / $100.00 / $528.59	Facility	26	$61.16	$100.00	$528.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $122.20 / $209.16 / $769.58	Professional		$122.20	$209.16	$769.58
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.16 / $113.71 / $413.18	Professional	26	$66.16	$113.71	$413.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.84 / $174.44 / $268.86	Professional		$107.84	$174.44	$268.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.15 / $92.16 / $134.47	Professional	26	$59.15	$92.16	$134.47
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $56.44 / $96.42 / $550.36	Facility	26	$56.44	$96.42	$550.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.98 / $162.74 / $226.98	Professional		$79.98	$162.74	$226.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.44 / $93.54 / $117.10	Professional	26	$56.44	$93.54	$117.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.98 / $71.09 / $226.76	Professional		$9.98	$71.09	$226.76
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $67.13 / $86.09 / $91.80	Facility	26	$67.13	$86.09	$91.80
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $54.27 / $74.40 / $94.84	Professional	26	$54.27	$74.40	$94.84
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $61.16 / $61.16 / $62.61	Facility	26	$61.16	$61.16	$62.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.20 / $191.75 / $242.76	Professional		$122.20	$191.75	$242.76
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.44 / $104.24 / $128.41	Professional	26	$64.44	$104.24	$128.41
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $528.59 / $528.59 / $882.62	Facility	26	$528.59	$528.59	$882.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.73 / $168.48 / $229.34	Professional		$112.73	$168.48	$229.34
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $62.37 / $90.06 / $121.31	Professional	26	$62.37	$90.06	$121.31
United Facility/Professional Professional Modifier Low / Median / High Price $103.95 / $164.89 / $243.32	Professional		$103.95	$164.89	$243.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.52 / $93.11 / $132.29	Professional	26	$58.52	$93.11	$132.29