Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.37 / $41.16 / $60.79	Facility	26	$27.37	$41.16	$60.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.54 / $155.29 / $272.70	Professional		$69.54	$155.29	$272.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.35 / $27.38 / $65.29	Professional	26	$16.35	$27.38	$65.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.50 / $39.35 / $44.12	Professional	26	$13.50	$39.35	$44.12
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $110.49 / $110.49	Facility	26	$100.00	$110.49	$110.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $106.94 / $187.49 / $676.85	Professional		$106.94	$187.49	$676.85
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.90 / $56.71 / $198.90	Professional	26	$32.90	$56.71	$198.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.39 / $168.56 / $255.43	Professional		$98.39	$168.56	$255.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.04 / $37.04 / $73.15	Professional	26	$20.04	$37.04	$73.15
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $18.41 / $38.65 / $1,002.46	Facility	26	$18.41	$38.65	$1,002.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.77 / $199.89 / $306.22	Professional		$42.77	$199.89	$306.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $36.25 / $58.36	Professional	26	$16.57	$36.25	$58.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.52 / $102.70 / $228.88	Professional		$21.52	$102.70	$228.88
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $28.50 / $39.60 / $48.24	Facility	26	$28.50	$39.60	$48.24
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $22.80 / $31.20 / $49.72	Professional	26	$22.80	$31.20	$49.72
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $32.61 / $32.61 / $32.90	Facility	26	$32.61	$32.61	$32.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.24 / $181.96 / $222.77	Professional		$119.24	$181.96	$222.77
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.42 / $55.73 / $67.48	Professional	26	$35.42	$55.73	$67.48
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $714.15 / $714.15 / $1,538.06	Facility	26	$714.15	$714.15	$1,538.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $105.80 / $160.29 / $242.99	Professional		$105.80	$160.29	$242.99
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $33.26 / $49.32 / $67.23	Professional	26	$33.26	$49.32	$67.23
United Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $127.62 / $251.17	Professional		$75.06	$127.62	$251.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.18 / $28.58 / $69.31	Professional	26	$19.18	$28.58	$69.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.01 / $89.01 / $89.01	Professional		$89.01	$89.01	$89.01
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $25.59 / $25.59 / $25.59	Professional	26	$25.59	$25.59	$25.59