Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.57 / $169.08 / $309.31	Facility	26	$95.57	$169.08	$309.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $387.95 / $770.14	Professional		$275.00	$387.95	$770.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.03 / $95.57 / $230.07	Professional	26	$78.03	$95.57	$230.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.20 / $145.68 / $145.68	Professional	26	$47.20	$145.68	$145.68
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $792.40 / $792.40	Facility	26	$346.39	$792.40	$792.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $417.70 / $735.39 / $2,854.54	Professional		$417.70	$735.39	$2,854.54
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $116.42 / $207.40 / $697.28	Professional	26	$116.42	$207.40	$697.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.94 / $588.45 / $1,060.63	Professional		$325.94	$588.45	$1,060.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.18 / $153.91 / $266.42	Professional	26	$84.18	$153.91	$266.42
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $93.89 / $191.77 / $539.79	Facility	26	$93.89	$191.77	$539.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $325.10 / $715.55 / $1,110.36	Professional		$325.10	$715.55	$1,110.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.39 / $179.57 / $232.38	Professional	26	$83.39	$179.57	$232.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.08 / $248.09 / $578.88	Professional		$48.08	$248.09	$578.88
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $138.05 / $166.54 / $171.52	Facility	26	$138.05	$166.54	$171.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $140.29 / $140.29 / $155.88	Professional		$140.29	$140.29	$155.88
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $116.74 / $152.40 / $196.10	Professional	26	$116.74	$152.40	$196.10
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $114.16 / $114.16 / $114.71	Facility	26	$114.16	$114.16	$114.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $477.87 / $719.68 / $870.13	Professional		$477.87	$719.68	$870.13
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $130.16 / $194.27 / $235.87	Professional	26	$130.16	$194.27	$235.87
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 $431.05 / $632.49 / $865.73	Professional		$431.05	$632.49	$865.73
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $116.42 / $173.69 / $234.52	Professional	26	$116.42	$173.69	$234.52
United Facility/Professional Professional Modifier Low / Median / High Price $283.45 / $407.43 / $900.05	Professional		$283.45	$407.43	$900.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.92 / $96.25 / $240.34	Professional	26	$77.92	$96.25	$240.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $304.98 / $304.98 / $304.98	Professional		$304.98	$304.98	$304.98
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $88.29 / $88.29 / $88.29	Professional	26	$88.29	$88.29	$88.29