Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.07 / $74.04 / $135.40	Facility	26	$42.07	$74.04	$135.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.37 / $363.17 / $553.13	Professional		$149.37	$363.17	$553.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.96 / $42.08 / $90.82	Professional	26	$34.96	$42.08	$90.82
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $49.83 / $100.00 / $731.61	Facility	26	$49.83	$100.00	$731.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $369.26 / $645.13 / $1,791.90	Professional		$369.26	$645.13	$1,791.90
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.82 / $87.87 / $258.60	Professional	26	$50.82	$87.87	$258.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $370.20 / $635.72 / $946.47	Professional		$370.20	$635.72	$946.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.40 / $78.11 / $122.67	Professional	26	$49.40	$78.11	$122.67
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $36.27 / $91.94 / $1,678.39	Facility	26	$36.27	$91.94	$1,678.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.07 / $589.33 / $894.00	Professional		$309.07	$589.33	$894.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.27 / $90.20 / $110.83	Professional	26	$36.27	$90.20	$110.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.21 / $321.22 / $637.87	Professional		$49.21	$321.22	$637.87
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $58.31 / $73.81 / $75.48	Facility	26	$58.31	$73.81	$75.48
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $203.30 / $203.30 / $273.14	Professional		$203.30	$203.30	$273.14
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $44.80 / $64.38 / $77.28	Professional	26	$44.80	$64.38	$77.28
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $49.83 / $49.83 / $50.73	Facility	26	$49.83	$49.83	$50.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $420.72 / $623.17 / $768.70	Professional		$420.72	$623.17	$768.70
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.02 / $84.62 / $104.04	Professional	26	$57.02	$84.62	$104.04
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $731.61 / $731.61 / $1,177.68	Facility	26	$731.61	$731.61	$1,177.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $383.00 / $559.14 / $809.34	Professional		$383.00	$559.14	$809.34
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $61.70 / $76.81 / $103.59	Professional	26	$61.70	$76.81	$103.59
United Facility/Professional Professional Modifier Low / Median / High Price $194.58 / $291.42 / $778.06	Professional		$194.58	$291.42	$778.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.75 / $41.54 / $101.19	Professional	26	$33.75	$41.54	$101.19