Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.32 / $26.11 / $42.44	Facility	26	$13.32	$26.11	$42.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.83 / $147.40 / $603.00	Professional		$56.83	$147.40	$603.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.32 / $37.63 / $263.89	Professional	26	$13.32	$37.63	$263.89
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $80.00 / $80.00	Facility	26	$70.00	$80.00	$80.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $67.45 / $118.13 / $402.45	Professional		$67.45	$118.13	$402.45
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.17 / $28.07 / $96.83	Professional	26	$16.17	$28.07	$96.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.52 / $100.20 / $163.57	Professional		$50.52	$100.20	$163.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.63 / $21.36 / $37.26	Professional	26	$11.63	$21.36	$37.26
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $24.64 / $32.29	Facility	26	$13.50	$24.64	$32.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.90 / $117.86 / $205.77	Professional		$58.90	$117.86	$205.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $25.90 / $32.58	Professional	26	$12.88	$25.90	$32.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.04 / $54.27 / $92.00	Professional		$9.04	$54.27	$92.00
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $18.13 / $23.13 / $23.45	Facility	26	$18.13	$23.13	$23.45
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $14.07 / $21.10 / $25.90	Professional	26	$14.07	$21.10	$25.90
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $15.86 / $15.86 / $16.00	Facility	26	$15.86	$15.86	$16.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $110.24 / $140.72	Professional		$73.20	$110.24	$140.72
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.04 / $27.09 / $32.81	Professional	26	$18.04	$27.09	$32.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.45 / $96.88 / $142.55	Professional		$67.45	$96.88	$142.55
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.17 / $24.22 / $32.19	Professional	26	$16.17	$24.22	$32.19
United Facility/Professional Professional Modifier Low / Median / High Price $45.40 / $77.56 / $146.26	Professional		$45.40	$77.56	$146.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.73 / $14.66 / $39.15	Professional	26	$10.73	$14.66	$39.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.12 / $52.12 / $52.12	Professional		$52.12	$52.12	$52.12
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.26 / $12.26 / $12.26	Professional	26	$12.26	$12.26	$12.26