Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.55 / $144.32 / $186.76	Professional		$103.55	$144.32	$186.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $56.09 / $77.81	Professional	26	$41.69	$56.09	$77.81
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $125.33 / $317.04 / $317.04	Facility	26	$125.33	$317.04	$317.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $172.33 / $305.06 / $1,061.93	Professional		$172.33	$305.06	$1,061.93
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.36 / $127.97 / $415.79	Professional	26	$71.36	$127.97	$415.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.42 / $142.97 / $204.54	Professional		$70.42	$142.97	$204.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.79 / $57.40 / $81.62	Professional	26	$28.79	$57.40	$81.62
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $65.41 / $110.88 / $155.62	Facility	26	$65.41	$110.88	$155.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $166.36 / $295.75 / $386.47	Professional		$166.36	$295.75	$386.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.90 / $117.49 / $155.62	Professional	26	$67.90	$117.49	$155.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.62 / $104.68 / $297.07	Professional		$19.62	$104.68	$297.07
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $83.60 / $101.84 / $127.20	Facility	26	$83.60	$101.84	$127.20
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $75.59 / $94.67 / $132.93	Professional	26	$75.59	$94.67	$132.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.15 / $290.35 / $340.96	Professional		$174.15	$290.35	$340.96
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.36 / $119.68 / $141.43	Professional	26	$71.36	$119.68	$141.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $172.33 / $238.37 / $318.32	Professional		$172.33	$238.37	$318.32
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $72.53 / $98.87 / $129.85	Professional	26	$72.53	$98.87	$129.85
United Facility/Professional Professional Modifier Low / Median / High Price $82.72 / $117.18 / $214.60	Professional		$82.72	$117.18	$214.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $49.08 / $111.24	Professional	26	$34.65	$49.08	$111.24