Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.02 / $80.16 / $186.76	Facility	26	$40.02	$80.16	$186.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.57 / $98.03 / $358.07	Professional		$58.57	$98.03	$358.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.94 / $47.78 / $108.17	Professional	26	$33.94	$47.78	$108.17
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $81.41 / $198.30 / $198.30	Facility	26	$81.41	$198.30	$198.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $79.83 / $141.27 / $696.80	Professional		$79.83	$141.27	$696.80
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.44 / $87.96 / $305.45	Professional	26	$49.44	$87.96	$305.45
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $88.42 / $114.80 / $230.64	Professional	50	$88.42	$114.80	$230.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.78 / $127.14 / $199.67	Professional		$81.78	$127.14	$199.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.01 / $72.40 / $114.57	Professional	26	$47.01	$72.40	$114.57
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $48.05 / $87.92 / $150.63	Facility	26	$48.05	$87.92	$150.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.29 / $154.58 / $232.24	Professional		$87.29	$154.58	$232.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.05 / $85.79 / $116.41	Professional	26	$48.05	$85.79	$116.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.62 / $65.14 / $147.48	Professional		$12.62	$65.14	$147.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $57.74 / $69.73 / $101.17	Facility	26	$57.74	$69.73	$101.17
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $59.59 / $75.50 / $101.64	Professional	26	$59.59	$75.50	$101.64
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $46.66 / $46.66 / $47.99	Facility	26	$46.66	$46.66	$47.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.75 / $131.86 / $162.79	Professional		$87.75	$131.86	$162.79
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.13 / $80.84 / $98.42	Professional	26	$54.13	$80.84	$98.42
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $385.75	Facility	26	$211.40	$211.40	$385.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $77.15 / $112.56 / $160.47	Professional		$77.15	$112.56	$160.47
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.59 / $69.84 / $94.31	Professional	26	$47.59	$69.84	$94.31
United Facility/Professional Professional Modifier Low / Median / High Price $63.16 / $96.30 / $172.38	Professional		$63.16	$96.30	$172.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.81 / $50.85 / $99.75	Professional	26	$36.81	$50.85	$99.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.79 / $62.79 / $62.79	Professional		$62.79	$62.79	$62.79
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $37.65 / $37.65	Professional	26	$37.65	$37.65	$37.65