Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.13 / $53.53 / $261.83	Facility	26	$33.13	$53.53	$261.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.13 / $125.00 / $291.50	Professional	26	$33.13	$125.00	$291.50
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $38.85 / $60.35 / $130.19	Facility	26	$38.85	$60.35	$130.19
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $68.22 / $234.00	Professional	26	$39.97	$68.22	$234.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.22 / $60.28 / $95.10	Professional	26	$39.22	$60.28	$95.10
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $37.34 / $70.34 / $84.28	Facility	26	$37.34	$70.34	$84.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.34 / $69.73 / $86.25	Professional	26	$37.34	$69.73	$86.25
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $46.75 / $56.94 / $58.96	Facility	26	$46.75	$56.94	$58.96
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $34.17 / $46.75 / $56.95	Professional	26	$34.17	$46.75	$56.95
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $38.85 / $38.85 / $38.96	Facility	26	$38.85	$38.85	$38.96
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.18 / $65.44 / $79.67	Professional	26	$44.18	$65.44	$79.67
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.25 / $58.82 / $80.98	Professional	26	$47.25	$58.82	$80.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.98 / $32.04 / $78.40	Professional	26	$26.98	$32.04	$78.40