Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.45 / $167.23 / $296.99	Facility	26	$102.45	$167.23	$296.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.43 / $251.48 / $1,013.00	Professional		$173.43	$251.48	$1,013.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.76 / $102.46 / $331.96	Professional	26	$81.76	$102.46	$331.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $164.94 / $317.17 / $331.63	Professional		$164.94	$317.17	$331.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $68.18 / $150.41 / $161.84	Professional	26	$68.18	$150.41	$161.84
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $189.86 / $404.21 / $404.21	Facility	26	$189.86	$404.21	$404.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $239.78 / $445.66 / $1,509.30	Professional		$239.78	$445.66	$1,509.30
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $124.28 / $223.67 / $734.25	Professional	26	$124.28	$223.67	$734.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.41 / $340.41 / $563.10	Professional		$203.41	$340.41	$563.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.96 / $168.13 / $275.76	Professional	26	$99.96	$168.13	$275.76
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $91.14 / $195.37 / $330.22	Facility	26	$91.14	$195.37	$330.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $184.92 / $368.37 / $498.68	Professional		$184.92	$368.37	$498.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.14 / $193.90 / $244.77	Professional	26	$91.14	$193.90	$244.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.38 / $180.77 / $366.55	Professional		$32.38	$180.77	$366.55
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $146.80 / $177.25 / $187.68	Facility	26	$146.80	$177.25	$187.68
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $126.96 / $156.40 / $204.98	Professional	26	$126.96	$156.40	$204.98
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $121.86 / $121.86 / $122.02	Facility	26	$121.86	$121.86	$122.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $271.67 / $404.22 / $498.64	Professional		$271.67	$404.22	$498.64
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $138.34 / $203.92 / $250.26	Professional	26	$138.34	$203.92	$250.26
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $385.75 / $385.75 / $446.45	Facility	26	$385.75	$385.75	$446.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $239.78 / $349.73 / $471.09	Professional		$239.78	$349.73	$471.09
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $124.28 / $178.25 / $239.82	Professional	26	$124.28	$178.25	$239.82
United Facility/Professional Professional Modifier Low / Median / High Price $180.81 / $202.37 / $480.48	Professional		$180.81	$202.37	$480.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.77 / $105.85 / $254.61	Professional	26	$93.77	$105.85	$254.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $198.23 / $198.23 / $198.23	Professional		$198.23	$198.23	$198.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $94.01 / $94.01 / $94.01	Professional	26	$94.01	$94.01	$94.01