Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.13 / $76.45 / $126.74	Facility	26	$39.13	$76.45	$126.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.59 / $146.07 / $493.37	Professional		$113.59	$146.07	$493.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.65 / $127.43 / $213.12	Professional		$84.65	$127.43	$213.12
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $81.20 / $154.38 / $154.38	Facility	26	$81.20	$154.38	$154.38
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $162.16 / $293.76 / $1,001.48	Professional		$162.16	$293.76	$1,001.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.24 / $215.71 / $376.65	Professional		$129.24	$215.71	$376.65
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $37.52 / $74.52 / $126.67	Facility	26	$37.52	$74.52	$126.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.42 / $247.74 / $326.05	Professional		$118.42	$247.74	$326.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.59 / $108.56 / $292.67	Professional		$21.59	$108.56	$292.67
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $55.65 / $67.59 / $70.34	Facility	26	$55.65	$67.59	$70.34
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $126.51 / $126.51 / $126.51	Professional		$126.51	$126.51	$126.51
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $46.61 / $46.61 / $46.66	Facility	26	$46.61	$46.61	$46.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.80 / $266.32 / $327.12	Professional		$179.80	$266.32	$327.12
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.45 / $446.45 / $782.93	Facility	26	$446.45	$446.45	$782.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.16 / $231.74 / $313.47	Professional		$162.16	$231.74	$313.47
United Facility/Professional Professional Modifier Low / Median / High Price $119.38 / $130.47 / $319.11	Professional		$119.38	$130.47	$319.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $130.37 / $130.37 / $130.37	Professional		$130.37	$130.37	$130.37