Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.44 / $45.51 / $58.92	Facility	26	$28.44	$45.51	$58.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.82 / $65.83 / $91.85	Professional		$33.82	$65.83	$91.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.35 / $27.27 / $55.87	Professional	26	$21.35	$27.27	$55.87
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.40 / $80.00 / $97.62	Facility	26	$41.40	$80.00	$97.62
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $62.61 / $113.96 / $438.23	Professional		$62.61	$113.96	$438.23
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.88 / $46.41 / $169.20	Professional	26	$27.88	$46.41	$169.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.37 / $82.95 / $175.95	Professional		$43.37	$82.95	$175.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.42 / $67.29	Professional	26	$22.91	$38.42	$67.29
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $19.20 / $28.66 / $57.38	Facility	26	$19.20	$28.66	$57.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.64 / $49.28 / $91.13	Professional		$31.64	$49.28	$91.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.20 / $28.66 / $52.76	Professional	26	$19.20	$28.66	$52.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.70 / $50.15 / $91.10	Professional		$9.70	$50.15	$91.10
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $32.34 / $40.24 / $41.48	Facility	26	$32.34	$40.24	$41.48
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $26.13 / $34.92 / $44.84	Professional	26	$26.13	$34.92	$44.84
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $27.63 / $27.63 / $27.88	Facility	26	$27.63	$27.63	$27.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.42 / $113.03 / $138.79	Professional		$76.42	$113.03	$138.79
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.34 / $45.65 / $55.33	Professional	26	$31.34	$45.65	$55.33
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $72.06 / $72.06 / $127.19	Facility	26	$72.06	$72.06	$127.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $89.32 / $126.85	Professional		$62.23	$89.32	$126.85
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $37.49 / $50.63	Professional	26	$28.18	$37.49	$50.63
United Facility/Professional Professional Modifier Low / Median / High Price $44.16 / $66.03 / $139.50	Professional		$44.16	$66.03	$139.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.56 / $34.84 / $58.89	Professional	26	$24.56	$34.84	$58.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.68 / $56.77 / $56.77	Professional		$41.68	$56.77	$56.77
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $16.84 / $21.37 / $21.37	Professional	26	$16.84	$21.37	$21.37