Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.46 / $263.08 / $432.99	Facility	26	$133.46	$263.08	$432.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $364.30 / $707.83	Professional		$275.00	$364.30	$707.83
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $1,108.64 / $1,108.64	Facility	26	$346.39	$1,108.64	$1,108.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $656.25 / $1,202.94 / $2,530.35	Professional		$656.25	$1,202.94	$2,530.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $496.98 / $932.98 / $1,563.87	Professional		$496.98	$932.98	$1,563.87
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $116.25 / $263.44 / $490.69	Facility	26	$116.25	$263.44	$490.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $537.23 / $1,030.52 / $1,434.05	Professional		$537.23	$1,030.52	$1,434.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.32 / $282.47 / $635.44	Professional		$52.32	$282.47	$635.44
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $193.05 / $233.22 / $239.86	Facility	26	$193.05	$233.22	$239.86
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $140.29 / $140.29 / $140.29	Professional		$140.29	$140.29	$140.29
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $159.00 / $159.00 / $160.41	Facility	26	$159.00	$159.00	$160.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $757.79 / $1,129.27 / $1,375.34	Professional		$757.79	$1,129.27	$1,375.34
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 $691.15 / $993.71 / $1,408.78	Professional		$691.15	$993.71	$1,408.78
United Facility/Professional Professional Modifier Low / Median / High Price $463.51 / $572.58 / $1,455.08	Professional		$463.51	$572.58	$1,455.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $341.04 / $341.04 / $341.04	Professional		$341.04	$341.04	$341.04