Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $494.81 / $629.70 / $1,027.06	Facility	26	$494.81	$629.70	$1,027.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,099.34 / $1,781.34 / $3,136.74	Professional		$1,099.34	$1,781.34	$3,136.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $363.17 / $494.81 / $1,027.06	Professional	26	$363.17	$494.81	$1,027.06
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $496.04 / $3,363.92 / $5,624.10	Facility	26	$496.04	$3,363.92	$5,624.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,773.16 / $2,946.34 / $10,678.50	Professional		$1,773.16	$2,946.34	$10,678.50
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $506.08 / $859.68 / $3,152.03	Professional	26	$506.08	$859.68	$3,152.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,584.24 / $2,631.54 / $3,952.43	Professional		$1,584.24	$2,631.54	$3,952.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $497.73 / $743.17 / $1,083.08	Professional	26	$497.73	$743.17	$1,083.08
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $460.89 / $831.11 / $10,775.99	Facility	26	$460.89	$831.11	$10,775.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,757.24 / $2,553.73 / $3,439.24	Professional		$1,757.24	$2,553.73	$3,439.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $460.89 / $800.85 / $1,016.65	Professional	26	$460.89	$800.85	$1,016.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $218.99 / $963.71 / $2,512.63	Professional		$218.99	$963.71	$2,512.63
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $598.40 / $696.60 / $744.60	Facility	26	$598.40	$696.60	$744.60
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 $515.59 / $649.79 / $783.75	Professional	26	$515.59	$649.79	$783.75
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $496.04 / $496.04 / $497.22	Facility	26	$496.04	$496.04	$497.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,797.35 / $2,832.07 / $3,389.63	Professional		$1,797.35	$2,832.07	$3,389.63
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $524.42 / $826.34 / $989.02	Professional	26	$524.42	$826.34	$989.02
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 $1,773.16 / $2,413.31 / $3,250.67	Professional		$1,773.16	$2,413.31	$3,250.67
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $505.89 / $715.26 / $963.42	Professional	26	$505.89	$715.26	$963.42
United Facility/Professional Professional Modifier Low / Median / High Price $1,600.79 / $2,128.61 / $3,593.59	Professional		$1,600.79	$2,128.61	$3,593.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $477.40 / $661.21 / $1,057.86	Professional	26	$477.40	$661.21	$1,057.86