Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.33 / $66.79 / $115.12	Facility	26	$34.33	$66.79	$115.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.28 / $315.05 / $551.02	Professional		$169.28	$315.05	$551.02
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.22 / $100.00 / $731.61	Facility	26	$41.22	$100.00	$731.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $318.52 / $542.78 / $1,553.08	Professional		$318.52	$542.78	$1,553.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.14 / $500.74 / $799.04	Professional		$254.14	$500.74	$799.04
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $31.31 / $74.90 / $1,678.39	Facility	26	$31.31	$74.90	$1,678.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $197.78 / $443.06 / $634.44	Professional		$197.78	$443.06	$634.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.11 / $275.68 / $552.92	Professional		$47.11	$275.68	$552.92
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $47.04 / $59.57 / $64.31	Facility	26	$47.04	$59.57	$64.31
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $273.14 / $273.14 / $273.14	Professional		$273.14	$273.14	$273.14
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $41.22 / $41.22 / $41.59	Facility	26	$41.22	$41.22	$41.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $362.16 / $536.51 / $663.54	Professional		$362.16	$536.51	$663.54
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 $332.18 / $482.32 / $663.32	Professional		$332.18	$482.32	$663.32
United Facility/Professional Professional Modifier Low / Median / High Price $168.60 / $238.90 / $645.12	Professional		$168.60	$238.90	$645.12