Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.77 / $170.59 / $298.08	Facility	26	$103.77	$170.59	$298.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.81 / $250.13 / $456.49	Professional		$141.81	$250.13	$456.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.76 / $103.77 / $202.29	Professional	26	$77.76	$103.77	$202.29
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $191.07 / $419.33 / $419.33	Facility	26	$191.07	$419.33	$419.33
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $218.53 / $378.61 / $3,391.09	Professional		$218.53	$378.61	$3,391.09
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.44 / $222.82 / $778.73	Professional	26	$128.44	$222.82	$778.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.67 / $324.89 / $538.19	Professional		$184.67	$324.89	$538.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.92 / $161.78 / $277.19	Professional	26	$90.92	$161.78	$277.19
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $85.73 / $190.55 / $8,105.48	Facility	26	$85.73	$190.55	$8,105.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.81 / $368.11 / $669.98	Professional		$170.81	$368.11	$669.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.66 / $175.34 / $234.95	Professional	26	$81.66	$175.34	$234.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $152.99 / $298.62	Professional		$28.61	$152.99	$298.62
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $142.50 / $174.55 / $185.59	Facility	26	$142.50	$174.55	$185.59
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $111.35 / $141.93 / $182.50	Professional	26	$111.35	$141.93	$182.50
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $125.93 / $125.93 / $126.13	Facility	26	$125.93	$125.93	$126.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $242.10 / $369.43 / $453.02	Professional		$242.10	$369.43	$453.02
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $142.28 / $213.62 / $262.70	Professional	26	$142.28	$213.62	$262.70
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,551.62 / $5,551.62 / $8,401.03	Facility	26	$5,551.62	$5,551.62	$8,401.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $218.53 / $325.24 / $443.30	Professional		$218.53	$325.24	$443.30
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $133.44 / $190.99 / $257.76	Professional	26	$133.44	$190.99	$257.76
United Facility/Professional Professional Modifier Low / Median / High Price $173.59 / $271.02 / $494.32	Professional		$173.59	$271.02	$494.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.87 / $104.63 / $262.20	Professional	26	$89.87	$104.63	$262.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $170.50 / $170.50 / $170.50	Professional		$170.50	$170.50	$170.50
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $95.37 / $95.37 / $95.37	Professional	26	$95.37	$95.37	$95.37