Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $316.37 / $401.90 / $656.55	Facility	26	$316.37	$401.90	$656.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $798.86 / $1,288.84 / $2,192.62	Professional		$798.86	$1,288.84	$2,192.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $237.16 / $316.38 / $622.63	Professional	26	$237.16	$316.38	$622.63
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $317.55 / $2,151.76 / $5,624.10	Facility	26	$317.55	$2,151.76	$5,624.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,294.52 / $2,146.03 / $7,780.80	Professional		$1,294.52	$2,146.03	$7,780.80
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $323.86 / $548.58 / $2,016.75	Professional	26	$323.86	$548.58	$2,016.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,101.02 / $1,919.80 / $2,892.97	Professional		$1,101.02	$1,919.80	$2,892.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $317.25 / $474.32 / $692.80	Professional	26	$317.25	$474.32	$692.80
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $293.68 / $529.58 / $10,775.99	Facility	26	$293.68	$529.58	$10,775.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,221.06 / $1,835.18 / $2,642.29	Professional		$1,221.06	$1,835.18	$2,642.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $293.68 / $511.42 / $655.63	Professional	26	$293.68	$511.42	$655.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $165.72 / $740.49 / $1,868.08	Professional		$165.72	$740.49	$1,868.08
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $378.28 / $444.75 / $483.69	Facility	26	$378.28	$444.75	$483.69
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,835.73 / $1,835.73 / $1,835.73	Professional		$1,835.73	$1,835.73	$1,835.73
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $279.60 / $420.60 / $524.25	Professional	26	$279.60	$420.60	$524.25
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $317.55 / $317.55 / $318.07	Facility	26	$317.55	$317.55	$318.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,282.16 / $2,062.80 / $2,468.91	Professional		$1,282.16	$2,062.80	$2,468.91
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $334.65 / $527.29 / $631.34	Professional	26	$334.65	$527.29	$631.34
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 $1,294.52 / $1,757.89 / $2,367.83	Professional		$1,294.52	$1,757.89	$2,367.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $323.86 / $457.55 / $616.30	Professional	26	$323.86	$457.55	$616.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,130.44 / $1,558.21 / $2,617.46	Professional		$1,130.44	$1,558.21	$2,617.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $291.06 / $432.11 / $675.67	Professional	26	$291.06	$432.11	$675.67