Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.21 / $52.63 / $258.16	Facility	26	$32.21	$52.63	$258.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.28 / $120.03 / $212.41	Professional		$84.28	$120.03	$212.41
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $38.51 / $127.16 / $127.16	Facility	26	$38.51	$127.16	$127.16
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $130.28 / $233.23 / $805.13	Professional		$130.28	$233.23	$805.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.32 / $172.87 / $301.45	Professional		$103.32	$172.87	$301.45
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $32.24 / $59.28 / $78.45	Facility	26	$32.24	$59.28	$78.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.92 / $191.11 / $256.51	Professional		$103.92	$191.11	$256.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.11 / $100.92 / $228.20	Professional		$21.11	$100.92	$228.20
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $46.16 / $55.36 / $56.28	Facility	26	$46.16	$55.36	$56.28
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $78.25 / $78.25 / $78.25	Professional		$78.25	$78.25	$78.25
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $38.39 / $38.39 / $38.51	Facility	26	$38.39	$38.39	$38.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.86 / $213.81 / $262.44	Professional		$144.86	$213.81	$262.44
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $379.18	Facility	26	$211.40	$211.40	$379.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $130.28 / $186.05 / $251.50	Professional		$130.28	$186.05	$251.50
United Facility/Professional Professional Modifier Low / Median / High Price $95.22 / $107.03 / $256.18	Professional		$95.22	$107.03	$256.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $105.46 / $105.46 / $105.46	Professional		$105.46	$105.46	$105.46