Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $68.55 / $205.41 / $205.41	Facility	26	$68.55	$205.41	$205.41
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $486.22 / $1,782.62 / $2,464.73	Professional		$486.22	$1,782.62	$2,464.73
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $90.93 / $313.70 / $417.53	Professional	26	$90.93	$313.70	$417.53
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $413.48 / $1,468.91 / $2,047.20	Professional	TC	$413.48	$1,468.91	$2,047.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,177.48 / $1,244.51 / $1,491.06	Professional		$1,177.48	$1,244.51	$1,491.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $201.47 / $212.93 / $255.12	Professional	26	$201.47	$212.93	$255.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $976.02 / $1,031.58 / $1,235.94	Professional	TC	$976.02	$1,031.58	$1,235.94
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $47.74 / $102.72 / $172.97	Facility	26	$47.74	$102.72	$172.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $278.69 / $557.25 / $764.38	Professional		$278.69	$557.25	$764.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.74 / $101.83 / $128.55	Professional	26	$47.74	$101.83	$128.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $230.64 / $448.51 / $646.72	Professional	TC	$230.64	$448.51	$646.72
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $72.03 / $97.82 / $100.50	Facility	26	$72.03	$97.82	$100.50
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $64.15 / $82.08 / $99.28	Professional	26	$64.15	$82.08	$99.28
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $287.63 / $378.16 / $461.63	Professional	TC	$287.63	$378.16	$461.63
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $66.59 / $66.59 / $68.55	Facility	26	$66.59	$66.59	$68.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $425.57 / $649.48 / $798.58	Professional		$425.57	$649.48	$798.58
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.03 / $114.35 / $140.60	Professional	26	$76.03	$114.35	$140.60
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $351.37 / $535.13 / $657.98	Professional	TC	$351.37	$535.13	$657.98