Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.25 / $107.64 / $170.12	Facility	26	$80.25	$107.64	$170.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.93 / $140.16 / $248.93	Professional		$107.93	$140.16	$248.93
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $83.63 / $274.01 / $274.01	Facility	26	$83.63	$274.01	$274.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $152.75 / $284.27 / $1,240.15	Professional		$152.75	$284.27	$1,240.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.99 / $208.88 / $409.23	Professional		$93.99	$208.88	$409.23
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $51.57 / $88.30 / $156.06	Facility	26	$51.57	$88.30	$156.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.55 / $178.92 / $338.78	Professional		$103.55	$178.92	$338.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.73 / $125.22 / $288.25	Professional		$25.73	$125.22	$288.25
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $88.20 / $119.76 / $122.61	Facility	26	$88.20	$119.76	$122.61
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $82.90 / $82.90 / $83.63	Facility	26	$82.90	$82.90	$83.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.22 / $311.29 / $379.92	Professional		$195.22	$311.29	$379.92
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 $197.74 / $269.95 / $366.08	Professional		$197.74	$269.95	$366.08
United Facility/Professional Professional Modifier Low / Median / High Price $134.13 / $224.26 / $401.80	Professional		$134.13	$224.26	$401.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $103.53 / $124.51 / $140.63	Professional		$103.53	$124.51	$140.63