Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $145.50 / $206.01 / $300.67	Facility	26	$145.50	$206.01	$300.67
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $71.73 / $127.24 / $258.32	Facility	53	$71.73	$127.24	$258.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.95 / $358.67 / $630.66	Professional		$263.95	$358.67	$630.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.97 / $145.51 / $528.08	Professional	26	$101.97	$145.51	$528.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $130.94 / $188.64 / $201.87	Professional	26	$130.94	$188.64	$201.87
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $760.56 / $985.36 / $985.36	Facility	26	$760.56	$985.36	$985.36
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $65.12 / $228.96 / $228.96	Facility	53	$65.12	$228.96	$228.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $351.24 / $605.15 / $2,010.60	Professional		$351.24	$605.15	$2,010.60
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $146.29 / $267.14 / $1,030.27	Professional	26	$146.29	$267.14	$1,030.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $306.08 / $485.24 / $760.32	Professional		$306.08	$485.24	$760.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $125.83 / $195.91 / $331.01	Professional	26	$125.83	$195.91	$331.01
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $103.56 / $218.63 / $367.29	Facility	26	$103.56	$218.63	$367.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $280.86 / $523.17 / $759.37	Professional		$280.86	$523.17	$759.37
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $102.31 / $211.49 / $279.56	Professional	26	$102.31	$211.49	$279.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.60 / $219.59 / $497.54	Professional		$39.60	$219.59	$497.54
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $168.56 / $206.66 / $210.91	Facility	26	$168.56	$206.66	$210.91
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $118.99 / $171.60 / $224.25	Professional	26	$118.99	$171.60	$224.25
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $142.13 / $142.13 / $142.24	Facility	26	$142.13	$142.13	$142.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.94 / $538.17 / $661.73	Professional		$363.94	$538.17	$661.73
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $160.84 / $237.40 / $291.50	Professional	26	$160.84	$237.40	$291.50
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $936.81 / $936.81 / $1,640.24	Facility	26	$936.81	$936.81	$1,640.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $329.87 / $464.12 / $634.13	Professional		$329.87	$464.12	$634.13
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $145.07 / $204.45 / $275.72	Professional	26	$145.07	$204.45	$275.72
United Facility/Professional Professional Modifier Low / Median / High Price $292.32 / $461.93 / $709.32	Professional		$292.32	$461.93	$709.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.60 / $177.84 / $308.88	Professional	26	$112.60	$177.84	$308.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $260.70 / $260.70 / $260.70	Professional		$260.70	$260.70	$260.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $109.12 / $109.12 / $109.12	Professional	26	$109.12	$109.12	$109.12