Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.31 / $65.34 / $107.39	Facility	26	$33.31	$65.34	$107.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.55 / $282.58 / $519.17	Professional		$159.55	$282.58	$519.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.67 / $33.31 / $65.73	Professional	26	$25.67	$33.31	$65.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.86 / $25.86 / $25.86	Professional	26	$25.86	$25.86	$25.86
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $39.29 / $100.00 / $731.61	Facility	26	$39.29	$100.00	$731.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $283.33 / $490.17 / $1,397.49	Professional		$283.33	$490.17	$1,397.49
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.65 / $66.95 / $249.32	Professional	26	$40.65	$66.95	$249.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.89 / $452.61 / $726.60	Professional		$286.89	$452.61	$726.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.58 / $61.32 / $95.95	Professional	26	$39.58	$61.32	$95.95
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $29.14 / $71.25 / $1,678.39	Facility	26	$29.14	$71.25	$1,678.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $237.77 / $480.96 / $645.69	Professional		$237.77	$480.96	$645.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.14 / $68.75 / $87.66	Professional	26	$29.14	$68.75	$87.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $232.19 / $468.46	Professional		$42.34	$232.19	$468.46
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $44.59 / $57.37 / $59.63	Facility	26	$44.59	$57.37	$59.63
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $270.14 / $273.14 / $273.14	Professional		$270.14	$273.14	$273.14
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $35.38 / $56.76 / $64.23	Professional	26	$35.38	$56.76	$64.23
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $39.29 / $39.29 / $39.86	Facility	26	$39.29	$39.29	$39.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $326.20 / $481.65 / $590.24	Professional		$326.20	$481.65	$590.24
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.21 / $66.56 / $80.61	Professional	26	$45.21	$66.56	$80.61
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 $298.91 / $432.39 / $622.64	Professional		$298.91	$432.39	$622.64
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.81 / $60.46 / $81.84	Professional	26	$47.81	$60.46	$81.84
United Facility/Professional Professional Modifier Low / Median / High Price $157.12 / $247.66 / $644.20	Professional		$157.12	$247.66	$644.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.98 / $33.35 / $80.23	Professional	26	$26.98	$33.35	$80.23