Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.14 / $476.56 / $1,485.56	Professional		$276.14	$476.56	$1,485.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.80 / $79.34 / $187.03	Professional	26	$57.80	$79.34	$187.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $125.55 / $125.55 / $125.55	Professional	26	$125.55	$125.55	$125.55
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $183.39 / $340.61 / $340.61	Facility	26	$183.39	$340.61	$340.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $552.90 / $1,098.14 / $4,205.03	Professional		$552.90	$1,098.14	$4,205.03
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $103.49 / $173.75 / $665.00	Professional	26	$103.49	$173.75	$665.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.14 / $500.49 / $675.23	Professional		$177.14	$500.49	$675.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.01 / $81.42 / $111.73	Professional	26	$39.01	$81.42	$111.73
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $73.16 / $146.03 / $228.75	Facility	26	$73.16	$146.03	$228.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $505.12 / $993.54 / $1,568.43	Professional		$505.12	$993.54	$1,568.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $94.21 / $147.69 / $209.23	Professional	26	$94.21	$147.69	$209.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $92.81 / $393.28 / $1,172.91	Professional		$92.81	$393.28	$1,172.91
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $122.55 / $148.74 / $149.41	Facility	26	$122.55	$148.74	$149.41
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $107.12 / $136.01 / $153.18	Professional	26	$107.12	$136.01	$153.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $658.21 / $1,043.33 / $1,294.94	Professional		$658.21	$1,043.33	$1,294.94
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.80 / $175.59 / $205.72	Professional	26	$103.80	$175.59	$205.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $579.75 / $852.00 / $1,092.32	Professional		$579.75	$852.00	$1,092.32
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $103.49 / $141.12 / $185.20	Professional	26	$103.49	$141.12	$185.20
United Facility/Professional Professional Modifier Low / Median / High Price $236.46 / $286.69 / $632.00	Professional		$236.46	$286.69	$632.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.48 / $47.86 / $124.16	Professional	26	$47.48	$47.86	$124.16