Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.65 / $114.22 / $180.89	Facility	26	$85.65	$114.22	$180.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.66 / $129.38 / $287.33	Professional		$103.66	$129.38	$287.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.80 / $71.01 / $145.05	Professional	26	$58.80	$71.01	$145.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.26 / $202.21 / $230.26	Professional		$139.26	$202.21	$230.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $58.77 / $63.19	Professional	26	$58.77	$58.77	$63.19
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $88.66 / $292.17 / $292.17	Facility	26	$88.66	$292.17	$292.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $121.64 / $228.80 / $951.00	Professional		$121.64	$228.80	$951.00
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.19 / $132.88 / $539.33	Professional	26	$76.19	$132.88	$539.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.42 / $192.69 / $340.86	Professional		$101.42	$192.69	$340.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.20 / $116.80 / $195.45	Professional	26	$69.20	$116.80	$195.45
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $59.76 / $99.59 / $169.93	Facility	26	$59.76	$99.59	$169.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.76 / $170.10 / $294.35	Professional		$106.76	$170.10	$294.35
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.40 / $92.36 / $161.54	Professional	26	$57.40	$92.36	$161.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.91 / $92.75 / $224.30	Professional		$19.91	$92.75	$224.30
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $93.10 / $127.75 / $129.97	Facility	26	$93.10	$127.75	$129.97
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $77.18 / $109.92 / $129.97	Professional	26	$77.18	$109.92	$129.97
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $87.88 / $87.88 / $88.66	Facility	26	$87.88	$87.88	$88.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.58 / $248.44 / $310.85	Professional		$157.58	$248.44	$310.85
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.26 / $143.66 / $175.98	Professional	26	$91.26	$143.66	$175.98
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 $156.62 / $219.82 / $296.64	Professional		$156.62	$219.82	$296.64
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $89.63 / $126.20 / $170.89	Professional	26	$89.63	$126.20	$170.89
United Facility/Professional Professional Modifier Low / Median / High Price $135.16 / $202.37 / $336.83	Professional		$135.16	$202.37	$336.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.31 / $120.96 / $194.78	Professional	26	$79.31	$120.96	$194.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.10 / $109.30 / $122.48	Professional		$91.10	$109.30	$122.48
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $53.28 / $63.28 / $68.53	Professional	26	$53.28	$63.28	$68.53