Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.36 / $95.55 / $152.84	Facility	26	$71.36	$95.55	$152.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.83 / $307.16 / $597.04	Professional		$225.83	$307.16	$597.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.39 / $66.23 / $126.59	Professional	26	$47.39	$66.23	$126.59
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $97.60 / $242.19 / $242.19	Facility	26	$97.60	$242.19	$242.19
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $340.96 / $604.42 / $2,434.88	Professional		$340.96	$604.42	$2,434.88
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.23 / $115.07 / $442.58	Professional	26	$71.23	$115.07	$442.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $248.45 / $449.38 / $920.03	Professional		$248.45	$449.38	$920.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $96.58 / $162.53	Professional	26	$57.50	$96.58	$162.53
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $64.37 / $120.15 / $762.02	Facility	26	$64.37	$120.15	$762.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $228.72 / $483.96 / $679.19	Professional		$228.72	$483.96	$679.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.80 / $116.18 / $149.46	Professional	26	$57.80	$116.18	$149.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.27 / $308.73 / $777.80	Professional		$65.27	$308.73	$777.80
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $87.45 / $105.19 / $106.53	Facility	26	$87.45	$105.19	$106.53
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $63.54 / $79.56 / $117.00	Professional	26	$63.54	$79.56	$117.00
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $71.56 / $71.56 / $72.66	Facility	26	$71.56	$71.56	$72.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $396.58 / $608.10 / $790.14	Professional		$396.58	$608.10	$790.14
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.48 / $122.44 / $149.03	Professional	26	$82.48	$122.44	$149.03
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $513.03 / $513.03 / $838.61	Facility	26	$513.03	$513.03	$838.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $340.96 / $511.14 / $720.97	Professional		$340.96	$511.14	$720.97
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $73.00 / $104.13 / $140.79	Professional	26	$73.00	$104.13	$140.79
United Facility/Professional Professional Modifier Low / Median / High Price $256.00 / $427.14 / $745.37	Professional		$256.00	$427.14	$745.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.22 / $87.79 / $154.47	Professional	26	$58.22	$87.79	$154.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $377.66 / $377.66 / $377.66	Professional		$377.66	$377.66	$377.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $57.35 / $57.35 / $57.35	Professional	26	$57.35	$57.35	$57.35