Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.84 / $51.73 / $84.53	Facility	26	$25.84	$51.73	$84.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.04 / $144.05 / $304.52	Professional		$93.04	$144.05	$304.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.30 / $25.84 / $51.79	Professional	26	$19.30	$25.84	$51.79
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $102.96 / $110.00	Facility	26	$100.00	$102.96	$110.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $172.44 / $328.82 / $1,172.70	Professional		$172.44	$328.82	$1,172.70
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.49 / $56.76 / $192.15	Professional	26	$31.49	$56.76	$192.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.62 / $212.95 / $442.17	Professional		$116.62	$212.95	$442.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.33 / $42.52 / $69.87	Professional	26	$24.33	$42.52	$69.87
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $28.70 / $53.06 / $490.69	Facility	26	$28.70	$53.06	$490.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.20 / $226.35 / $359.66	Professional		$109.20	$226.35	$359.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.77 / $51.55 / $64.31	Professional	26	$25.77	$51.55	$64.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.45 / $163.00 / $277.62	Professional		$27.45	$163.00	$277.62
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $37.38 / $44.92 / $46.90	Facility	26	$37.38	$44.92	$46.90
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $31.50 / $39.86 / $48.30	Professional	26	$31.50	$39.86	$48.30
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $30.80 / $30.80 / $31.53	Facility	26	$30.80	$30.80	$31.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.68 / $312.39 / $379.61	Professional		$201.68	$312.39	$379.61
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.09 / $53.37 / $65.69	Professional	26	$36.09	$53.37	$65.69
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 $190.81 / $277.43 / $372.50	Professional		$190.81	$277.43	$372.50
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $32.64 / $47.46 / $64.38	Professional	26	$32.64	$47.46	$64.38
United Facility/Professional Professional Modifier Low / Median / High Price $115.04 / $152.83 / $355.76	Professional		$115.04	$152.83	$355.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.89 / $27.45 / $66.50	Professional	26	$24.89	$27.45	$66.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $153.38 / $153.38 / $153.38	Professional		$153.38	$153.38	$153.38
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.79 / $23.79 / $23.79	Professional	26	$23.79	$23.79	$23.79