Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.33 / $133.76 / $218.86	Facility	26	$67.33	$133.76	$218.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.60 / $275.00 / $519.38	Professional		$203.60	$275.00	$519.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.56 / $72.47 / $134.66	Professional	26	$54.56	$72.47	$134.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $108.04 / $108.04 / $108.04	Professional	26	$108.04	$108.04	$108.04
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $565.04 / $565.04 / $565.04	Facility	26	$565.04	$565.04	$565.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $286.44 / $494.80 / $2,293.84	Professional		$286.44	$494.80	$2,293.84
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.70 / $141.79 / $523.40	Professional	26	$82.70	$141.79	$523.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.31 / $473.26 / $731.08	Professional		$223.31	$473.26	$731.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.81 / $108.86 / $190.10	Professional	26	$59.81	$108.86	$190.10
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $66.64 / $136.21 / $539.79	Facility	26	$66.64	$136.21	$539.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $270.33 / $541.08 / $935.84	Professional		$270.33	$541.08	$935.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.21 / $127.46 / $165.49	Professional	26	$59.21	$127.46	$165.49
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 $98.38 / $118.06 / $121.27	Facility	26	$98.38	$118.06	$121.27
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $75.98 / $109.55 / $126.60	Professional	26	$75.98	$109.55	$126.60
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $81.09 / $81.09 / $81.80	Facility	26	$81.09	$81.09	$81.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $319.61 / $481.89 / $589.67	Professional		$319.61	$481.89	$589.67
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.42 / $138.55 / $167.78	Professional	26	$91.42	$138.55	$167.78
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 $286.44 / $423.50 / $628.22	Professional		$286.44	$423.50	$628.22
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $82.70 / $123.87 / $166.47	Professional	26	$82.70	$123.87	$166.47
United Facility/Professional Professional Modifier Low / Median / High Price $199.09 / $340.39 / $641.37	Professional		$199.09	$340.39	$641.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.22 / $68.20 / $171.01	Professional	26	$55.22	$68.20	$171.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $230.53 / $230.53 / $230.53	Professional		$230.53	$230.53	$230.53
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $62.65 / $62.65 / $62.65	Professional	26	$62.65	$62.65	$62.65