Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.08 / $55.05 / $67.31	Facility	26	$42.08	$55.05	$67.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.62 / $99.47 / $156.94	Professional		$81.62	$99.47	$156.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.58 / $35.39 / $65.20	Professional	26	$28.58	$35.39	$65.20
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $56.14 / $128.35 / $140.77	Facility	26	$56.14	$128.35	$140.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $105.71 / $190.06 / $764.48	Professional		$105.71	$190.06	$764.48
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.29 / $68.12 / $254.33	Professional	26	$38.29	$68.12	$254.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.92 / $160.07 / $276.14	Professional		$95.92	$160.07	$276.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.11 / $56.07 / $94.76	Professional	26	$34.11	$56.07	$94.76
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $30.87 / $50.39 / $89.67	Facility	26	$30.87	$50.39	$89.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.10 / $142.80 / $236.40	Professional		$85.10	$142.80	$236.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.72 / $48.37 / $81.05	Professional	26	$29.72	$48.37	$81.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.36 / $103.50 / $237.12	Professional		$23.36	$103.50	$237.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $51.14 / $61.86 / $63.65	Facility	26	$51.14	$61.86	$63.65
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $51.15 / $71.15	Professional	26	$37.11	$51.15	$71.15
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $42.50 / $42.58 / $42.58	Facility	26	$42.50	$42.58	$42.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.49 / $197.83 / $242.65	Professional		$125.49	$197.83	$242.65
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.75 / $70.76 / $85.90	Professional	26	$43.75	$70.76	$85.90
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $217.18 / $217.18 / $354.01	Facility	26	$217.18	$217.18	$354.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.12 / $170.56 / $229.30	Professional		$120.12	$170.56	$229.30
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $43.43 / $60.50 / $80.20	Professional	26	$43.43	$60.50	$80.20
United Facility/Professional Professional Modifier Low / Median / High Price $95.10 / $144.29 / $251.04	Professional		$95.10	$144.29	$251.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.29 / $50.36 / $89.81	Professional	26	$34.29	$50.36	$89.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $73.98 / $101.28 / $101.28	Professional		$73.98	$101.28	$101.28
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $25.67 / $32.57 / $32.57	Professional	26	$25.67	$32.57	$32.57