Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.84 / $74.16 / $125.19	Facility	26	$37.84	$74.16	$125.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.17 / $109.51 / $492.00	Professional		$87.17	$109.51	$492.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.09 / $164.50 / $186.91	Professional		$135.09	$164.50	$186.91
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $78.81 / $149.85 / $149.85	Facility	26	$78.81	$149.85	$149.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $122.43 / $223.67 / $763.28	Professional		$122.43	$223.67	$763.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.97 / $167.90 / $286.91	Professional		$103.97	$167.90	$286.91
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $33.47 / $72.40 / $121.31	Facility	26	$33.47	$72.40	$121.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.45 / $188.02 / $244.11	Professional		$91.45	$188.02	$244.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.11 / $100.68 / $227.98	Professional		$21.11	$100.68	$227.98
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $54.43 / $65.59 / $69.68	Facility	26	$54.43	$65.59	$69.68
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $44.85 / $44.85 / $45.24	Facility	26	$44.85	$44.85	$45.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.12 / $203.53 / $250.26	Professional		$137.12	$203.53	$250.26
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 $122.43 / $176.12 / $239.01	Professional		$122.43	$176.12	$239.01
United Facility/Professional Professional Modifier Low / Median / High Price $92.03 / $101.23 / $252.00	Professional		$92.03	$101.23	$252.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.42 / $99.42 / $99.42	Professional		$99.42	$99.42	$99.42