Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.95 / $110.39 / $171.53	Facility	26	$66.95	$110.39	$171.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.58 / $230.09 / $460.14	Professional		$172.58	$230.09	$460.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $61.70 / $127.03	Professional	26	$42.60	$61.70	$127.03
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $124.48 / $267.93 / $267.93	Facility	26	$124.48	$267.93	$267.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $301.16 / $552.01 / $1,897.58	Professional		$301.16	$552.01	$1,897.58
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.89 / $140.21 / $492.08	Professional	26	$80.89	$140.21	$492.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.22 / $390.11 / $711.70	Professional		$205.22	$390.11	$711.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.02 / $93.07 / $179.38	Professional	26	$52.02	$93.07	$179.38
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $51.91 / $107.66 / $490.69	Facility	26	$51.91	$107.66	$490.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $211.83 / $426.13 / $607.05	Professional		$211.83	$426.13	$607.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.62 / $99.29 / $144.77	Professional	26	$46.62	$99.29	$144.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.31 / $239.04 / $488.99	Professional		$42.31	$239.04	$488.99
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $80.94 / $113.65 / $119.26	Facility	26	$80.94	$113.65	$119.26
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $140.29 / $140.29 / $140.29	Professional		$140.29	$140.29	$140.29
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $56.80 / $89.11 / $121.09	Professional	26	$56.80	$89.11	$121.09
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $80.63 / $80.63 / $80.89	Facility	26	$80.63	$80.63	$80.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.83 / $512.09 / $627.37	Professional		$340.83	$512.09	$627.37
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.56 / $137.00 / $168.50	Professional	26	$87.56	$137.00	$168.50
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 $315.08 / $455.78 / $615.12	Professional		$315.08	$455.78	$615.12
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $82.24 / $121.25 / $166.10	Professional	26	$82.24	$121.25	$166.10
United Facility/Professional Professional Modifier Low / Median / High Price $200.59 / $250.87 / $614.64	Professional		$200.59	$250.87	$614.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.25 / $70.66 / $169.10	Professional	26	$51.25	$70.66	$169.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $246.37 / $246.37 / $246.37	Professional		$246.37	$246.37	$246.37
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.92 / $61.92 / $61.92	Professional	26	$61.92	$61.92	$61.92