Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.37 / $221.40 / $356.15	Facility	26	$173.37	$221.40	$356.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $757.34 / $1,192.56 / $1,972.10	Professional		$757.34	$1,192.56	$1,972.10
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $173.05 / $1,180.80 / $5,624.10	Facility	26	$173.05	$1,180.80	$5,624.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,239.00 / $2,058.16 / $7,417.05	Professional		$1,239.00	$2,058.16	$7,417.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $956.77 / $1,850.81 / $2,775.96	Professional		$956.77	$1,850.81	$2,775.96
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $159.15 / $286.98 / $10,775.99	Facility	26	$159.15	$286.98	$10,775.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,061.17 / $1,594.88 / $2,642.29	Professional		$1,061.17	$1,594.88	$2,642.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.09 / $714.40 / $1,850.34	Professional		$120.09	$714.40	$1,850.34
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $209.55 / $245.22 / $269.04	Facility	26	$209.55	$245.22	$269.04
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,835.73 / $1,835.73 / $2,039.70	Professional		$1,835.73	$1,835.73	$2,039.70
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $173.05 / $173.05 / $174.12	Facility	26	$173.05	$173.05	$174.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,199.52 / $1,978.34 / $2,367.82	Professional		$1,199.52	$1,978.34	$2,367.82
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,624.10 / $5,624.10 / $9,482.39	Facility	26	$5,624.10	$5,624.10	$9,482.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,247.40 / $1,676.37 / $2,258.03	Professional		$1,247.40	$1,676.37	$2,258.03
United Facility/Professional Professional Modifier Low / Median / High Price $1,029.43 / $1,430.00 / $2,510.31	Professional		$1,029.43	$1,430.00	$2,510.31