Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.38 / $95.45 / $400.28	Facility	26	$49.38	$95.45	$400.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $138.47 / $270.87	Professional		$96.60	$138.47	$270.87
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $195.30 / $195.30	Facility	26	$100.00	$195.30	$195.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $159.85 / $273.10 / $1,286.55	Professional		$159.85	$273.10	$1,286.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.74 / $225.53 / $363.50	Professional		$115.74	$225.53	$363.50
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $52.89 / $98.72 / $2,015.51	Facility	26	$52.89	$98.72	$2,015.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.98 / $216.12 / $373.12	Professional		$117.98	$216.12	$373.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.66 / $103.10 / $228.28	Professional		$21.66	$103.10	$228.28
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $68.37 / $84.92 / $87.10	Facility	26	$68.37	$84.92	$87.10
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $58.89 / $58.89 / $58.95	Facility	26	$58.89	$58.89	$58.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.23 / $266.87 / $319.87	Professional		$177.23	$266.87	$319.87
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,387.45 / $1,387.45 / $2,298.07	Facility	26	$1,387.45	$1,387.45	$2,298.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $159.85 / $232.51 / $312.07	Professional		$159.85	$232.51	$312.07
United Facility/Professional Professional Modifier Low / Median / High Price $113.32 / $158.33 / $314.52	Professional		$113.32	$158.33	$314.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.49 / $125.49 / $125.49	Professional		$125.49	$125.49	$125.49