Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.74 / $114.95 / $210.65	Facility	26	$63.74	$114.95	$210.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.87 / $165.11 / $612.00	Professional		$113.87	$165.11	$612.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.81 / $175.40 / $225.62	Professional		$112.81	$175.40	$225.62
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $117.85 / $251.32 / $251.32	Facility	26	$117.85	$251.32	$251.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $163.09 / $293.39 / $985.28	Professional		$163.09	$293.39	$985.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.54 / $219.90 / $368.44	Professional		$134.54	$219.90	$368.44
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $56.42 / $121.52 / $204.42	Facility	26	$56.42	$121.52	$204.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.42 / $245.34 / $316.10	Professional		$118.42	$245.34	$316.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.43 / $100.68 / $227.98	Professional		$21.43	$100.68	$227.98
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $91.26 / $110.08 / $116.28	Facility	26	$91.26	$110.08	$116.28
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $75.65 / $75.65 / $75.86	Facility	26	$75.65	$75.65	$75.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.46 / $267.83 / $325.24	Professional		$181.46	$267.83	$325.24
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 $163.09 / $233.06 / $311.68	Professional		$163.09	$233.06	$311.68
United Facility/Professional Professional Modifier Low / Median / High Price $123.43 / $134.07 / $322.04	Professional		$123.43	$134.07	$322.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $126.94 / $126.94 / $126.94	Professional		$126.94	$126.94	$126.94