Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.38 / $40.54 / $123.75	Facility	26	$29.38	$40.54	$123.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.91 / $157.30 / $259.54	Professional		$122.91	$157.30	$259.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.30 / $26.63 / $43.49	Professional	26	$22.30	$26.63	$43.49
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $32.15 / $102.96 / $102.96	Facility	26	$32.15	$102.96	$102.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $206.79 / $350.68 / $1,131.98	Professional		$206.79	$350.68	$1,131.98
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.79 / $55.53 / $196.80	Professional	26	$32.79	$55.53	$196.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $171.49 / $281.18 / $478.36	Professional		$171.49	$281.18	$478.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.15 / $42.73 / $72.17	Professional	26	$27.15	$42.73	$72.17
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $26.55 / $50.75 / $84.45	Facility	26	$26.55	$50.75	$84.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $136.40 / $290.58 / $418.03	Professional		$136.40	$290.58	$418.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.54 / $49.21 / $62.44	Professional	26	$26.54	$49.21	$62.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $144.45 / $311.48	Professional		$28.84	$144.45	$311.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $37.33 / $44.01 / $47.57	Facility	26	$37.33	$44.01	$47.57
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $27.74 / $37.33 / $46.23	Professional	26	$27.74	$37.33	$46.23
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $31.53 / $31.53 / $32.15	Facility	26	$31.53	$31.53	$32.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $228.37 / $337.08 / $409.60	Professional		$228.37	$337.08	$409.60
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.09 / $53.26 / $64.67	Professional	26	$36.09	$53.26	$64.67
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $377.73	Facility	26	$211.40	$211.40	$377.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $207.44 / $287.27 / $386.96	Professional		$207.44	$287.27	$386.96
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $32.79 / $45.36 / $60.78	Professional	26	$32.79	$45.36	$60.78
United Facility/Professional Professional Modifier Low / Median / High Price $170.43 / $257.83 / $431.87	Professional		$170.43	$257.83	$431.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.98 / $42.60 / $70.16	Professional	26	$26.98	$42.60	$70.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $152.74 / $152.74 / $152.74	Professional		$152.74	$152.74	$152.74
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.26 / $23.26 / $23.26	Professional	26	$23.26	$23.26	$23.26