Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.71 / $40.31 / $55.37	Facility	26	$25.71	$40.31	$55.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.84 / $111.02 / $200.94	Professional		$72.84	$111.02	$200.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.87 / $25.71 / $55.37	Professional	26	$20.87	$25.71	$55.37
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $25.82 / $80.00 / $100.00	Facility	26	$25.82	$80.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $104.87 / $163.59 / $606.15	Professional		$104.87	$163.59	$606.15
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.33 / $42.58 / $157.80	Professional	26	$26.33	$42.58	$157.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $131.84 / $229.82	Professional		$73.48	$131.84	$229.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.35 / $35.11 / $58.19	Professional	26	$21.35	$35.11	$58.19
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $34.02 / $48.44	Facility	26	$19.95	$34.02	$48.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.03 / $121.32 / $194.46	Professional		$67.03	$121.32	$194.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.07 / $35.38 / $50.18	Professional	26	$19.07	$35.38	$50.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.83 / $68.53 / $155.26	Professional		$14.83	$68.53	$155.26
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $28.42 / $37.77 / $38.86	Facility	26	$28.42	$37.77	$38.86
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $23.32 / $34.20 / $42.75	Professional	26	$23.32	$34.20	$42.75
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $25.82 / $25.82 / $26.05	Facility	26	$25.82	$25.82	$26.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.14 / $160.85 / $197.77	Professional		$106.14	$160.85	$197.77
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.47 / $41.44 / $51.70	Professional	26	$28.47	$41.44	$51.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.87 / $138.71 / $189.52	Professional		$104.87	$138.71	$189.52
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.33 / $37.07 / $50.47	Professional	26	$26.33	$37.07	$50.47
United Facility/Professional Professional Modifier Low / Median / High Price $74.33 / $134.09 / $214.44	Professional		$74.33	$134.09	$214.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.09 / $32.46 / $55.05	Professional	26	$24.09	$32.46	$55.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.32 / $56.32 / $78.27	Professional		$56.32	$56.32	$78.27
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.74 / $15.74 / $20.26	Professional	26	$15.74	$15.74	$20.26