Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.33 / $133.00 / $218.86	Facility	26	$67.33	$133.00	$218.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.36 / $280.44 / $516.74	Professional		$215.36	$280.44	$516.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $67.33 / $134.56	Professional	26	$55.00	$67.33	$134.56
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $561.91 / $561.91 / $561.91	Facility	26	$561.91	$561.91	$561.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $285.52 / $487.09 / $2,293.84	Professional		$285.52	$487.09	$2,293.84
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.16 / $141.00 / $523.40	Professional	26	$83.16	$141.00	$523.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.10 / $470.06 / $726.15	Professional		$221.10	$470.06	$726.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.67 / $108.65 / $189.01	Professional	26	$59.67	$108.65	$189.01
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $73.80 / $135.68 / $539.79	Facility	26	$73.80	$135.68	$539.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $268.77 / $537.07 / $929.49	Professional		$268.77	$537.07	$929.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $66.27 / $133.19 / $164.64	Professional	26	$66.27	$133.19	$164.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $201.84 / $457.79	Professional		$36.65	$201.84	$457.79
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $97.83 / $117.40 / $121.27	Facility	26	$97.83	$117.40	$121.27
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $72.76 / $106.20 / $125.93	Professional	26	$72.76	$106.20	$125.93
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $81.34 / $81.34 / $81.54	Facility	26	$81.34	$81.34	$81.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.52 / $478.74 / $586.87	Professional		$316.52	$478.74	$586.87
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.95 / $137.77 / $166.84	Professional	26	$91.95	$137.77	$166.84
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $851.78	Facility	26	$346.39	$346.39	$851.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $285.52 / $420.74 / $624.11	Professional		$285.52	$420.74	$624.11
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $83.16 / $123.18 / $165.55	Professional	26	$83.16	$123.18	$165.55
United Facility/Professional Professional Modifier Low / Median / High Price $198.78 / $321.14 / $638.28	Professional		$198.78	$321.14	$638.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.22 / $67.87 / $172.14	Professional	26	$55.22	$67.87	$172.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $227.77 / $227.77 / $227.77	Professional		$227.77	$227.77	$227.77
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $62.26 / $62.26 / $62.26	Professional	26	$62.26	$62.26	$62.26