Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.43 / $124.55 / $221.20	Facility	26	$76.43	$124.55	$221.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.51 / $165.10 / $301.37	Professional		$120.51	$165.10	$301.37
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $141.35 / $308.83 / $308.83	Facility	26	$141.35	$308.83	$308.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $182.80 / $313.82 / $1,209.00	Professional		$182.80	$313.82	$1,209.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.53 / $246.49 / $417.55	Professional		$134.53	$246.49	$417.55
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $54.12 / $112.49 / $3,447.33	Facility	26	$54.12	$112.49	$3,447.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $146.63 / $295.39 / $381.09	Professional		$146.63	$295.39	$381.09
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 $84.93 / $111.65 / $136.01	Facility	26	$84.93	$111.65	$136.01
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $115.41 / $115.41 / $115.41	Professional		$115.41	$115.41	$115.41
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $91.51 / $91.51 / $92.77	Facility	26	$91.51	$91.51	$92.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.45 / $313.50 / $380.80	Professional		$204.45	$313.50	$380.80
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,727.91 / $2,727.91 / $3,312.81	Facility	26	$2,727.91	$2,727.91	$3,312.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $184.34 / $276.80 / $363.81	Professional		$184.34	$276.80	$363.81
United Facility/Professional Professional Modifier Low / Median / High Price $128.47 / $158.27 / $362.85	Professional		$128.47	$158.27	$362.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $146.93 / $146.93 / $146.93	Professional		$146.93	$146.93	$146.93