Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.53 / $88.21 / $144.13	Facility	26	$45.53	$88.21	$144.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.25 / $130.79 / $247.61	Professional		$81.25	$130.79	$247.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.69 / $45.53 / $91.25	Professional	26	$32.69	$45.53	$91.25
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $189.21 / $189.21	Facility	26	$100.00	$189.21	$189.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $143.50 / $257.82 / $939.75	Professional		$143.50	$257.82	$939.75
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.98 / $98.53 / $341.78	Professional	26	$54.98	$98.53	$341.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.25 / $181.30 / $350.61	Professional		$99.25	$181.30	$350.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.37 / $73.93 / $124.98	Professional	26	$41.37	$73.93	$124.98
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $38.75 / $88.06 / $635.38	Facility	26	$38.75	$88.06	$635.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $189.58 / $282.97	Professional		$86.98	$189.58	$282.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.75 / $83.79 / $112.08	Professional	26	$38.75	$83.79	$112.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.67 / $102.70 / $228.88	Professional		$21.67	$102.70	$228.88
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $59.78 / $80.31 / $82.41	Facility	26	$59.78	$80.31	$82.41
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $48.64 / $68.91 / $82.41	Professional	26	$48.64	$68.91	$82.41
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $53.91 / $53.91 / $56.21	Facility	26	$53.91	$53.91	$56.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.54 / $251.95 / $307.43	Professional		$167.54	$251.95	$307.43
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.89 / $94.19 / $115.56	Professional	26	$62.89	$94.19	$115.56
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.45 / $446.45 / $782.93	Facility	26	$446.45	$446.45	$782.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $144.61 / $218.44 / $294.61	Professional		$144.61	$218.44	$294.61
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $57.47 / $84.26 / $112.06	Professional	26	$57.47	$84.26	$112.06
United Facility/Professional Professional Modifier Low / Median / High Price $97.02 / $124.49 / $296.29	Professional		$97.02	$124.49	$296.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.48 / $48.04 / $115.89	Professional	26	$41.48	$48.04	$115.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $126.92 / $126.92 / $126.92	Professional		$126.92	$126.92	$126.92
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $44.16 / $44.16 / $44.16	Professional	26	$44.16	$44.16	$44.16