Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $275.05 / $631.67 / $962.49	Facility	26	$275.05	$631.67	$962.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $888.75 / $958.88 / $1,917.76	Professional		$888.75	$958.88	$1,917.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $816.35 / $816.35 / $816.35	Professional		$816.35	$816.35	$816.35
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $371.46 / $1,291.31 / $1,374.41	Facility	26	$371.46	$1,291.31	$1,374.41
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,201.66 / $2,104.46 / $7,811.55	Professional		$1,201.66	$2,104.46	$7,811.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,103.90 / $1,872.46 / $2,939.57	Professional		$1,103.90	$1,872.46	$2,939.57
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $261.64 / $637.47 / $2,160.25	Facility	26	$261.64	$637.47	$2,160.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $913.88 / $2,031.10 / $2,643.47	Professional		$913.88	$2,031.10	$2,643.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $178.57 / $789.86 / $1,930.11	Professional		$178.57	$789.86	$1,930.11
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $386.12 / $540.02 / $562.13	Facility	26	$386.12	$540.02	$562.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $599.05 / $599.05 / $599.05	Professional		$599.05	$599.05	$599.05
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $371.46 / $371.46 / $383.42	Facility	26	$371.46	$371.46	$383.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,378.96 / $2,068.12 / $2,471.98	Professional		$1,378.96	$2,068.12	$2,471.98
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,374.41 / $1,374.41 / $2,406.69	Facility	26	$1,374.41	$1,374.41	$2,406.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,201.66 / $1,851.91 / $2,436.82	Professional		$1,201.66	$1,851.91	$2,436.82
United Facility/Professional Professional Modifier Low / Median / High Price $1,106.94 / $1,187.31 / $2,317.08	Professional		$1,106.94	$1,187.31	$2,317.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,047.71 / $1,047.71 / $1,047.71	Professional		$1,047.71	$1,047.71	$1,047.71