Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.33 / $118.04 / $189.43	Facility	26	$86.33	$118.04	$189.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.65 / $176.50 / $383.02	Professional		$143.65	$176.50	$383.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.42 / $73.70 / $179.64	Professional	26	$62.42	$73.70	$179.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $515.00 / $515.00 / $515.00	Professional		$515.00	$515.00	$515.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $129.22 / $129.22 / $129.22	Professional	26	$129.22	$129.22	$129.22
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $124.27 / $268.52 / $302.75	Facility	26	$124.27	$268.52	$302.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $192.41 / $340.63 / $1,328.33	Professional		$192.41	$340.63	$1,328.33
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.58 / $148.96 / $553.28	Professional	26	$84.58	$148.96	$553.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.01 / $275.58 / $478.25	Professional		$163.01	$275.58	$478.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.15 / $116.24 / $201.64	Professional	26	$70.15	$116.24	$201.64
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $63.68 / $103.97 / $184.72	Facility	26	$63.68	$103.97	$184.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $146.43 / $237.85 / $396.16	Professional		$146.43	$237.85	$396.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.32 / $99.80 / $166.04	Professional	26	$61.32	$99.80	$166.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.18 / $152.42 / $317.00	Professional		$31.18	$152.42	$317.00
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $98.98 / $131.32 / $133.33	Facility	26	$98.98	$131.32	$133.33
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $80.59 / $117.16 / $136.07	Professional	26	$80.59	$117.16	$136.07
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $90.94 / $91.51 / $91.51	Facility	26	$90.94	$91.51	$91.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.27 / $346.97 / $420.89	Professional		$218.27	$346.97	$420.89
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.61 / $151.41 / $181.23	Professional	26	$93.61	$151.41	$181.23
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $513.03 / $513.03 / $838.61	Facility	26	$513.03	$513.03	$838.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $211.60 / $297.70 / $394.65	Professional		$211.60	$297.70	$394.65
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $93.32 / $129.36 / $169.80	Professional	26	$93.32	$129.36	$169.80
United Facility/Professional Professional Modifier Low / Median / High Price $160.44 / $239.65 / $431.99	Professional		$160.44	$239.65	$431.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.09 / $105.48 / $192.15	Professional	26	$69.09	$105.48	$192.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.63 / $174.46 / $174.46	Professional		$128.63	$174.46	$174.46
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $55.21 / $69.84 / $69.84	Professional	26	$55.21	$69.84	$69.84