Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.74 / $188.68 / $308.41	Facility	26	$95.74	$188.68	$308.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $334.63 / $475.00 / $868.87	Professional		$334.63	$475.00	$868.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.09 / $128.55 / $268.36	Professional	26	$86.09	$128.55	$268.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $162.63 / $162.63 / $162.63	Professional	26	$162.63	$162.63	$162.63
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $789.76 / $789.76 / $789.76	Facility	26	$789.76	$789.76	$789.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $396.08 / $676.03 / $3,480.43	Professional		$396.08	$676.03	$3,480.43
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $115.96 / $202.91 / $701.72	Professional	26	$115.96	$202.91	$701.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.16 / $597.22 / $1,027.14	Professional		$302.16	$597.22	$1,027.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.07 / $154.49 / $269.77	Professional	26	$84.07	$154.49	$269.77
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $93.52 / $191.97 / $1,102.78	Facility	26	$93.52	$191.97	$1,102.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $385.70 / $707.90 / $1,294.73	Professional		$385.70	$707.90	$1,294.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $84.32 / $184.15 / $234.57	Professional	26	$84.32	$184.15	$234.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $268.38 / $603.77	Professional		$56.10	$268.38	$603.77
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $137.50 / $165.65 / $170.85	Facility	26	$137.50	$165.65	$170.85
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $113.53 / $157.47 / $189.61	Professional	26	$113.53	$157.47	$189.61
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $113.70 / $113.70 / $114.25	Facility	26	$113.70	$113.70	$114.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $440.24 / $662.99 / $837.72	Professional		$440.24	$662.99	$837.72
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $130.41 / $196.60 / $235.87	Professional	26	$130.41	$196.60	$235.87
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $714.15 / $714.15 / $1,538.06	Facility	26	$714.15	$714.15	$1,538.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $396.86 / $582.66 / $844.28	Professional		$396.86	$582.66	$844.28
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $115.96 / $173.00 / $233.60	Professional	26	$115.96	$173.00	$233.60
United Facility/Professional Professional Modifier Low / Median / High Price $270.56 / $500.62 / $886.92	Professional		$270.56	$500.62	$886.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.61 / $100.68 / $249.21	Professional	26	$77.61	$100.68	$249.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $315.64 / $315.64 / $315.64	Professional		$315.64	$315.64	$315.64
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $87.91 / $87.91 / $87.91	Professional	26	$87.91	$87.91	$87.91