Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.56 / $78.11 / $93.57	Facility	26	$57.56	$78.11	$93.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.68 / $71.03 / $88.87	Professional		$53.68	$71.03	$88.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.45 / $49.24 / $62.35	Professional	26	$38.45	$49.24	$62.35
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $60.32 / $201.33 / $201.33	Facility	26	$60.32	$201.33	$201.33
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $61.12 / $105.59 / $542.33	Professional		$61.12	$105.59	$542.33
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $80.03 / $363.53	Professional	26	$44.14	$80.03	$363.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $115.11 / $196.23	Professional		$68.59	$115.11	$196.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.98 / $78.81 / $133.47	Professional	26	$46.98	$78.81	$133.47
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $40.04 / $66.56 / $112.88	Facility	26	$40.04	$66.56	$112.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.44 / $88.79 / $159.37	Professional		$55.44	$88.79	$159.37
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.36 / $62.79 / $109.15	Professional	26	$38.36	$62.79	$109.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.26 / $65.66 / $150.68	Professional		$14.26	$65.66	$150.68
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $58.08 / $85.98 / $88.44	Facility	26	$58.08	$85.98	$88.44
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $48.26 / $62.02 / $88.44	Professional	26	$48.26	$62.02	$88.44
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $58.89 / $58.89 / $60.32	Facility	26	$58.89	$58.89	$60.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.40 / $144.41 / $175.07	Professional		$91.40	$144.41	$175.07
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.52 / $98.78 / $120.21	Professional	26	$62.52	$98.78	$120.21
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $217.18 / $217.18 / $367.45	Facility	26	$217.18	$217.18	$367.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $63.26 / $66.59 / $128.63	Professional		$63.26	$66.59	$128.63
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $43.26 / $45.54 / $87.98	Professional	26	$43.26	$45.54	$87.98
United Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $106.20 / $183.34	Professional		$75.59	$106.20	$183.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.10 / $77.41 / $133.91	Professional	26	$53.10	$77.41	$133.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.56 / $64.18 / $71.34	Professional		$53.56	$64.18	$71.34
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.72 / $43.74 / $47.39	Professional	26	$36.72	$43.74	$47.39