Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.65 / $90.16 / $160.13	Facility	26	$55.65	$90.16	$160.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.70 / $138.97 / $259.02	Professional		$100.70	$138.97	$259.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.51 / $47.32 / $101.08	Professional	26	$30.51	$47.32	$101.08
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $101.33 / $217.99 / $217.99	Facility	26	$101.33	$217.99	$217.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $136.26 / $267.10 / $924.75	Professional		$136.26	$267.10	$924.75
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.83 / $115.57 / $405.38	Professional	26	$63.83	$115.57	$405.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.60 / $204.64 / $340.29	Professional		$111.60	$204.64	$340.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $71.80 / $144.09	Professional	26	$36.15	$71.80	$144.09
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $42.01 / $76.72 / $3,447.33	Facility	26	$42.01	$76.72	$3,447.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.11 / $246.20 / $320.70	Professional		$118.11	$246.20	$320.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.14 / $73.40 / $117.49	Professional	26	$37.14	$73.40	$117.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.67 / $102.70 / $228.88	Professional		$21.67	$102.70	$228.88
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $56.43 / $79.12 / $97.15	Facility	26	$56.43	$79.12	$97.15
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $46.80 / $62.38 / $89.53	Professional	26	$46.80	$62.38	$89.53
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $66.27 / $66.27 / $66.59	Facility	26	$66.27	$66.27	$66.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.34 / $254.01 / $307.50	Professional		$163.34	$254.01	$307.50
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.25 / $112.23 / $138.04	Professional	26	$71.25	$112.23	$138.04
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,064.48 / $2,064.48 / $2,727.91	Facility	26	$2,064.48	$2,064.48	$2,727.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $152.46 / $223.52 / $303.91	Professional		$152.46	$223.52	$303.91
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $67.91 / $99.33 / $136.07	Professional	26	$67.91	$99.33	$136.07
United Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $121.89 / $298.12	Professional		$109.71	$121.89	$298.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.36 / $49.48 / $126.48	Professional	26	$35.36	$49.48	$126.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $118.53 / $118.53 / $118.53	Professional		$118.53	$118.53	$118.53
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $49.98 / $49.98 / $49.98	Professional	26	$49.98	$49.98	$49.98