Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.89 / $163.47 / $250.74	Facility	26	$71.89	$163.47	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.66 / $153.74 / $307.48	Professional		$130.66	$153.74	$307.48
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.08 / $336.07 / $657.04	Facility	26	$100.08	$336.07	$657.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $197.74 / $344.43 / $1,269.90	Professional		$197.74	$344.43	$1,269.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.52 / $299.08 / $473.37	Professional		$180.52	$299.08	$473.37
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $68.20 / $162.97 / $1,073.72	Facility	26	$68.20	$162.97	$1,073.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.56 / $323.79 / $426.82	Professional		$147.56	$323.79	$426.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.55 / $122.76 / $276.70	Professional		$20.55	$122.76	$276.70
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $100.45 / $141.37 / $146.72	Facility	26	$100.45	$141.37	$146.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $77.43 / $115.68 / $201.16	Professional		$77.43	$115.68	$201.16
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $100.08 / $100.08 / $100.08	Facility	26	$100.08	$100.08	$100.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.04 / $338.29 / $403.66	Professional		$225.04	$338.29	$403.66
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $657.04 / $657.04 / $1,088.88	Facility	26	$657.04	$657.04	$1,088.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $197.74 / $304.74 / $399.70	Professional		$197.74	$304.74	$399.70
United Facility/Professional Professional Modifier Low / Median / High Price $173.16 / $190.83 / $381.99	Professional		$173.16	$190.83	$381.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $168.74 / $168.74 / $168.74	Professional		$168.74	$168.74	$168.74