Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.28 / $307.19 / $506.57	Facility	26	$158.28	$307.19	$506.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $402.08 / $587.61 / $1,378.47	Professional		$402.08	$587.61	$1,378.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $701.65 / $701.65 / $701.65	Professional		$701.65	$701.65	$701.65
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $1,307.92 / $1,307.92 / $1,307.92	Facility	26	$1,307.92	$1,307.92	$1,307.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $627.40 / $1,049.05 / $4,924.22	Professional		$627.40	$1,049.05	$4,924.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $468.96 / $936.87 / $1,535.51	Professional		$468.96	$936.87	$1,535.51
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $146.43 / $313.05 / $2,015.51	Facility	26	$146.43	$313.05	$2,015.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $531.65 / $1,082.55 / $1,879.13	Professional		$531.65	$1,082.55	$1,879.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $86.39 / $390.84 / $962.15	Professional		$86.39	$390.84	$962.15
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $227.15 / $274.87 / $282.20	Facility	26	$227.15	$274.87	$282.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $481.07 / $481.07 / $534.53	Professional		$481.07	$481.07	$534.53
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $188.00 / $188.00 / $188.74	Facility	26	$188.00	$188.00	$188.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $682.01 / $1,029.13 / $1,313.80	Professional		$682.01	$1,029.13	$1,313.80
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,387.45 / $1,387.45 / $2,298.07	Facility	26	$1,387.45	$1,387.45	$2,298.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $627.40 / $904.44 / $1,341.64	Professional		$627.40	$904.44	$1,341.64
United Facility/Professional Professional Modifier Low / Median / High Price $429.46 / $771.10 / $1,383.54	Professional		$429.46	$771.10	$1,383.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $484.98 / $484.98 / $484.98	Professional		$484.98	$484.98	$484.98