Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.95 / $155.65 / $302.49	Facility	26	$93.95	$155.65	$302.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.29 / $157.82 / $290.02	Professional		$126.29	$157.82	$290.02
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $112.80 / $464.00 / $484.26	Facility	26	$112.80	$464.00	$484.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $184.80 / $316.66 / $1,132.95	Professional		$184.80	$316.66	$1,132.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.91 / $279.68 / $417.20	Professional		$165.91	$279.68	$417.20
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $81.53 / $189.50 / $747.49	Facility	26	$81.53	$189.50	$747.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.13 / $298.55 / $379.30	Professional		$131.13	$298.55	$379.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.84 / $148.90 / $290.85	Professional		$27.84	$148.90	$290.85
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $132.50 / $164.57 / $167.96	Facility	26	$132.50	$164.57	$167.96
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $112.80 / $112.80 / $112.88	Facility	26	$112.80	$112.80	$112.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.23 / $305.88 / $372.53	Professional		$207.23	$305.88	$372.53
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $484.26 / $484.26 / $803.73	Facility	26	$484.26	$484.26	$803.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $184.80 / $274.69 / $360.18	Professional		$184.80	$274.69	$360.18
United Facility/Professional Professional Modifier Low / Median / High Price $120.25 / $156.80 / $366.51	Professional		$120.25	$156.80	$366.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $148.06 / $148.06 / $148.06	Professional		$148.06	$148.06	$148.06