Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.07 / $110.73 / $203.02	Facility	26	$63.07	$110.73	$203.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.87 / $169.60 / $623.00	Professional		$119.87	$169.60	$623.00
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $124.93 / $284.58 / $284.58	Facility	26	$124.93	$284.58	$284.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $202.36 / $391.75 / $1,463.10	Professional		$202.36	$391.75	$1,463.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.16 / $272.89 / $556.66	Professional		$145.16	$272.89	$556.66
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $55.18 / $117.87 / $199.93	Facility	26	$55.18	$117.87	$199.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $133.19 / $265.64 / $410.07	Professional		$133.19	$265.64	$410.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.07 / $154.55 / $356.32	Professional		$29.07	$154.55	$356.32
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $92.34 / $114.57 / $123.28	Facility	26	$92.34	$114.57	$123.28
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $79.28 / $79.28 / $84.09	Facility	26	$79.28	$79.28	$84.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $242.29 / $367.50 / $486.46	Professional		$242.29	$367.50	$486.46
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 $202.36 / $319.44 / $445.82	Professional		$202.36	$319.44	$445.82
United Facility/Professional Professional Modifier Low / Median / High Price $131.69 / $160.38 / $399.25	Professional		$131.69	$160.38	$399.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $194.94 / $194.94 / $194.94	Professional		$194.94	$194.94	$194.94