Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $546.29 / $698.23 / $1,135.68	Facility	26	$546.29	$698.23	$1,135.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,225.50 / $1,975.83 / $3,520.36	Professional		$1,225.50	$1,975.83	$3,520.36
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $548.13 / $3,718.96 / $5,624.10	Facility	26	$548.13	$3,718.96	$5,624.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,954.72 / $3,249.52 / $11,782.43	Professional		$1,954.72	$3,249.52	$11,782.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,813.92 / $2,901.92 / $4,359.68	Professional		$1,813.92	$2,901.92	$4,359.68
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $508.85 / $917.59 / $10,775.99	Facility	26	$508.85	$917.59	$10,775.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,921.73 / $2,864.47 / $3,928.44	Professional		$1,921.73	$2,864.47	$3,928.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $236.51 / $1,105.77 / $2,808.08	Professional		$236.51	$1,105.77	$2,808.08
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $660.97 / $769.63 / $822.80	Facility	26	$660.97	$769.63	$822.80
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
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $548.13 / $548.13 / $549.77	Facility	26	$548.13	$548.13	$549.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,982.30 / $3,123.49 / $3,738.42	Professional		$1,982.30	$3,123.49	$3,738.42
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 $1,954.72 / $2,662.47 / $3,586.28	Professional		$1,954.72	$2,662.47	$3,586.28
United Facility/Professional Professional Modifier Low / Median / High Price $1,791.26 / $2,686.44 / $4,118.43	Professional		$1,791.26	$2,686.44	$4,118.43