Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.58 / $88.02 / $359.56	Facility	26	$45.58	$88.02	$359.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.72 / $134.25 / $268.50	Professional		$93.72	$134.25	$268.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.14 / $45.58 / $98.14	Professional	26	$33.14	$45.58	$98.14
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $178.64 / $178.64	Facility	26	$100.00	$178.64	$178.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $153.63 / $262.30 / $1,963.99	Professional		$153.63	$262.30	$1,963.99
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.98 / $94.26 / $549.82	Professional	26	$54.98	$94.26	$549.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.90 / $216.30 / $385.84	Professional		$114.90	$216.30	$385.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.75 / $73.65 / $118.73	Professional	26	$42.75	$73.65	$118.73
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $40.29 / $89.44 / $4,890.87	Facility	26	$40.29	$89.44	$4,890.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.68 / $211.22 / $361.87	Professional		$96.68	$211.22	$361.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $86.44 / $108.90	Professional	26	$40.29	$86.44	$108.90
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 $64.34 / $77.81 / $82.41	Facility	26	$64.34	$77.81	$82.41
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $49.45 / $70.68 / $83.08	Professional	26	$49.45	$70.68	$83.08
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $53.47 / $53.47 / $53.91	Facility	26	$53.47	$53.47	$53.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.06 / $262.30 / $317.97	Professional		$171.06	$262.30	$317.97
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.62 / $90.56 / $111.38	Professional	26	$60.62	$90.56	$111.38
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $3,403.52 / $3,403.52 / $5,427.71	Facility	26	$3,403.52	$3,403.52	$5,427.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $155.22 / $228.79 / $303.05	Professional		$155.22	$228.79	$303.05
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $54.98 / $80.95 / $113.12	Professional	26	$54.98	$80.95	$113.12
United Facility/Professional Professional Modifier Low / Median / High Price $108.99 / $157.04 / $316.33	Professional		$108.99	$157.04	$316.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.11 / $48.04 / $113.38	Professional	26	$42.11	$48.04	$113.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.67 / $125.67 / $125.67	Professional		$125.67	$125.67	$125.67
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $41.34 / $41.34 / $41.34	Professional	26	$41.34	$41.34	$41.34