Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.09 / $98.06 / $154.22	Facility	26	$73.09	$98.06	$154.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.79 / $364.25 / $727.30	Professional		$275.79	$364.25	$727.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.40 / $62.15 / $138.63	Professional	26	$50.40	$62.15	$138.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $697.54 / $697.54 / $697.54	Professional		$697.54	$697.54	$697.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $87.90 / $100.60 / $174.00	Professional	26	$87.90	$100.60	$174.00
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $76.31 / $251.32 / $251.32	Facility	26	$76.31	$251.32	$251.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $378.86 / $734.53 / $3,046.13	Professional		$378.86	$734.53	$3,046.13
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.94 / $119.74 / $774.69	Professional	26	$68.94	$119.74	$774.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.02 / $585.25 / $1,082.07	Professional		$321.02	$585.25	$1,082.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.44 / $99.03 / $167.95	Professional	26	$57.44	$99.03	$167.95
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $47.25 / $80.94 / $142.34	Facility	26	$47.25	$80.94	$142.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $258.20 / $453.31 / $904.66	Professional		$258.20	$453.31	$904.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.72 / $74.70 / $133.01	Professional	26	$46.72	$74.70	$133.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.44 / $302.76 / $826.25	Professional		$68.44	$302.76	$826.25
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $80.36 / $109.76 / $111.89	Facility	26	$80.36	$109.76	$111.89
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $65.93 / $92.34 / $113.16	Professional	26	$65.93	$92.34	$113.16
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $75.20 / $75.20 / $76.31	Facility	26	$75.20	$75.20	$76.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $494.86 / $772.25 / $954.27	Professional		$494.86	$772.25	$954.27
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.56 / $123.47 / $151.49	Professional	26	$78.56	$123.47	$151.49
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 $474.94 / $674.96 / $903.67	Professional		$474.94	$674.96	$903.67
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $76.69 / $108.63 / $146.22	Professional	26	$76.69	$108.63	$146.22
United Facility/Professional Professional Modifier Low / Median / High Price $325.99 / $567.61 / $996.41	Professional		$325.99	$567.61	$996.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.78 / $107.96 / $164.75	Professional	26	$68.78	$107.96	$164.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $287.66 / $348.77 / $404.07	Professional		$287.66	$348.77	$404.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $45.83 / $54.38 / $58.85	Professional	26	$45.83	$54.38	$58.85