Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.25 / $184.97 / $308.64	Facility	26	$93.25	$184.97	$308.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.25 / $130.50 / $308.64	Professional	26	$93.25	$130.50	$308.64
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $113.34 / $754.00 / $2,871.86	Facility	26	$113.34	$754.00	$2,871.86
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.58 / $196.74 / $2,660.92	Professional	26	$114.58	$196.74	$2,660.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $113.57 / $175.13 / $277.77	Professional	26	$113.57	$175.13	$277.77
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $83.08 / $211.18 / $6,659.19	Facility	26	$83.08	$211.18	$6,659.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.08 / $202.38 / $250.31	Professional	26	$83.08	$202.38	$250.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $135.79 / $163.71 / $182.56	Facility	26	$135.79	$163.71	$182.56
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $117.30 / $154.80 / $194.58	Professional	26	$117.30	$154.80	$194.58
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $113.34 / $113.34 / $125.00	Facility	26	$113.34	$113.34	$125.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $127.40 / $191.95 / $232.45	Professional	26	$127.40	$191.95	$232.45
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,871.86 / $2,871.86 / $4,641.51	Facility	26	$2,871.86	$2,871.86	$4,641.51
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $140.88 / $171.62 / $234.52	Professional	26	$140.88	$171.62	$234.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.45 / $97.66 / $235.60	Professional	26	$75.45	$97.66	$235.60