Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.69 / $113.74 / $187.31	Facility	26	$57.69	$113.74	$187.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.16 / $233.12 / $423.26	Professional		$128.16	$233.12	$423.26
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $119.00 / $242.28 / $242.28	Facility	26	$119.00	$242.28	$242.28
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $194.04 / $338.80 / $3,098.01	Professional		$194.04	$338.80	$3,098.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.76 / $299.70 / $504.37	Professional		$170.76	$299.70	$504.37
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $52.88 / $116.73 / $13,984.77	Facility	26	$52.88	$116.73	$13,984.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.44 / $345.63 / $608.41	Professional		$162.44	$345.63	$608.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $148.77 / $312.97	Professional		$29.46	$148.77	$312.97
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $84.05 / $100.31 / $105.19	Facility	26	$84.05	$100.31	$105.19
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $69.76 / $69.76 / $69.92	Facility	26	$69.76	$69.76	$69.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $220.93 / $335.37 / $409.36	Professional		$220.93	$335.37	$409.36
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $9,254.52 / $9,254.52 / $14,373.77	Facility	26	$9,254.52	$9,254.52	$14,373.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $194.04 / $294.55 / $415.70	Professional		$194.04	$294.55	$415.70
United Facility/Professional Professional Modifier Low / Median / High Price $153.38 / $207.10 / $451.12	Professional		$153.38	$207.10	$451.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $163.04 / $163.04 / $163.04	Professional		$163.04	$163.04	$163.04