Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $441.77 / $562.44 / $917.47	Facility	26	$441.77	$562.44	$917.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $999.08 / $1,605.78 / $2,912.27	Professional		$999.08	$1,605.78	$2,912.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $325.89 / $437.19 / $906.00	Professional	26	$325.89	$437.19	$906.00
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $443.03 / $3,007.60 / $5,624.10	Facility	26	$443.03	$3,007.60	$5,624.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,595.75 / $2,652.65 / $9,627.75	Professional		$1,595.75	$2,652.65	$9,627.75
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $452.02 / $767.85 / $2,820.30	Professional	26	$452.02	$767.85	$2,820.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,470.77 / $2,369.40 / $3,563.22	Professional		$1,470.77	$2,369.40	$3,563.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $444.63 / $663.77 / $968.33	Professional	26	$444.63	$663.77	$968.33
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $411.66 / $742.34 / $10,775.99	Facility	26	$411.66	$742.34	$10,775.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,631.47 / $2,452.02 / $3,294.20	Professional		$1,631.47	$2,452.02	$3,294.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $411.66 / $715.14 / $908.82	Professional	26	$411.66	$715.14	$908.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $192.31 / $856.27 / $2,211.31	Professional		$192.31	$856.27	$2,211.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $533.72 / $621.62 / $665.04	Facility	26	$533.72	$621.62	$665.04
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,039.70 / $2,039.70 / $2,039.70	Professional		$2,039.70	$2,039.70	$2,039.70
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $392.00 / $533.72 / $686.08	Professional	26	$392.00	$533.72	$686.08
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $443.03 / $443.03 / $444.66	Facility	26	$443.03	$443.03	$444.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,618.20 / $2,549.78 / $3,051.76	Professional		$1,618.20	$2,549.78	$3,051.76
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $468.41 / $738.07 / $883.38	Professional	26	$468.41	$738.07	$883.38
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 $1,595.75 / $2,175.34 / $2,930.12	Professional		$1,595.75	$2,175.34	$2,930.12
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $451.84 / $639.65 / $861.59	Professional	26	$451.84	$639.65	$861.59
United Facility/Professional Professional Modifier Low / Median / High Price $1,456.41 / $2,052.21 / $3,235.39	Professional		$1,456.41	$2,052.21	$3,235.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $426.80 / $593.92 / $945.75	Professional	26	$426.80	$593.92	$945.75