Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.69 / $72.36 / $112.02	Facility	26	$53.69	$72.36	$112.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.31 / $105.51 / $216.97	Professional		$77.31	$105.51	$216.97
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $55.75 / $186.22 / $186.22	Facility	26	$55.75	$186.22	$186.22
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $112.42 / $219.64 / $914.78	Professional		$112.42	$219.64	$914.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.23 / $158.22 / $316.20	Professional		$70.23	$158.22	$316.20
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $34.56 / $59.36 / $104.61	Facility	26	$34.56	$59.36	$104.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $136.50 / $261.85	Professional		$75.79	$136.50	$261.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.18 / $100.65 / $232.98	Professional		$23.18	$100.65	$232.98
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $58.31 / $79.73 / $81.73	Facility	26	$58.31	$79.73	$81.73
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $55.27 / $55.27 / $55.75	Facility	26	$55.27	$55.27	$55.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.06 / $239.46 / $291.36	Professional		$150.06	$239.46	$291.36
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $459.43 / $459.43 / $513.03	Facility	26	$459.43	$459.43	$513.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $149.22 / $207.51 / $281.60	Professional		$149.22	$207.51	$281.60
United Facility/Professional Professional Modifier Low / Median / High Price $103.70 / $176.00 / $308.95	Professional		$103.70	$176.00	$308.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.86 / $103.39 / $117.61	Professional		$85.86	$103.39	$117.61