Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.82 / $93.33 / $187.79	Facility	26	$56.82	$93.33	$187.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.20 / $138.54 / $359.22	Professional		$110.20	$138.54	$359.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.85 / $130.87 / $247.68	Professional		$97.85	$130.87	$247.68
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $105.29 / $224.03 / $224.03	Facility	26	$105.29	$224.03	$224.03
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $158.00 / $298.29 / $1,015.95	Professional		$158.00	$298.29	$1,015.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.75 / $217.68 / $380.31	Professional		$130.75	$217.68	$380.31
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $50.53 / $108.11 / $183.08	Facility	26	$50.53	$108.11	$183.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.59 / $246.91 / $321.89	Professional		$120.59	$246.91	$321.89
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 $75.58 / $98.30 / $104.04	Facility	26	$75.58	$98.30	$104.04
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $78.25 / $86.94 / $115.13	Professional		$78.25	$86.94	$115.13
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $67.50 / $67.50 / $67.64	Facility	26	$67.50	$67.50	$67.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.43 / $268.44 / $333.68	Professional		$180.43	$268.44	$333.68
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 $158.00 / $234.03 / $315.24	Professional		$158.00	$234.03	$315.24
United Facility/Professional Professional Modifier Low / Median / High Price $120.18 / $130.47 / $317.76	Professional		$120.18	$130.47	$317.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $133.88 / $133.88 / $133.88	Professional		$133.88	$133.88	$133.88