Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.65 / $114.33 / $189.76	Facility	26	$58.65	$114.33	$189.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.50 / $186.16 / $383.36	Professional		$106.50	$186.16	$383.36
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $119.00 / $240.69 / $240.69	Facility	26	$119.00	$240.69	$240.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $157.08 / $275.20 / $3,401.00	Professional		$157.08	$275.20	$3,401.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.05 / $253.62 / $431.22	Professional		$140.05	$253.62	$431.22
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $64.78 / $117.49 / $8,105.48	Facility	26	$64.78	$117.49	$8,105.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.88 / $288.32 / $556.45	Professional		$138.88	$288.32	$556.45
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 $86.35 / $102.66 / $107.20	Facility	26	$86.35	$102.66	$107.20
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $70.22 / $70.22 / $71.75	Facility	26	$70.22	$70.22	$71.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.54 / $269.29 / $332.28	Professional		$176.54	$269.29	$332.28
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 $157.08 / $236.66 / $350.41	Professional		$157.08	$236.66	$350.41
United Facility/Professional Professional Modifier Low / Median / High Price $128.12 / $217.80 / $392.78	Professional		$128.12	$217.80	$392.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $126.54 / $126.54 / $126.54	Professional		$126.54	$126.54	$126.54