Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.14 / $151.50 / $240.19	Facility	26	$110.14	$151.50	$240.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $163.01 / $270.81	Professional		$129.00	$163.01	$270.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $143.97 / $143.97 / $143.97	Professional		$143.97	$143.97	$143.97
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $116.54 / $383.01 / $383.01	Facility	26	$116.54	$383.01	$383.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $162.52 / $299.93 / $1,288.50	Professional		$162.52	$299.93	$1,288.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.52 / $269.91 / $460.12	Professional		$161.52	$269.91	$460.12
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $79.05 / $131.97 / $226.98	Facility	26	$79.05	$131.97	$226.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.04 / $211.44 / $379.49	Professional		$131.04	$211.44	$379.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.93 / $156.42 / $366.70	Professional		$30.93	$156.42	$366.70
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $135.68 / $166.92 / $171.52	Facility	26	$135.68	$166.92	$171.52
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $114.61 / $114.61 / $116.54	Facility	26	$114.61	$114.61	$116.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.54 / $338.98 / $412.55	Professional		$214.54	$338.98	$412.55
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 $206.05 / $292.58 / $392.30	Professional		$206.05	$292.58	$392.30
United Facility/Professional Professional Modifier Low / Median / High Price $170.40 / $257.08 / $437.37	Professional		$170.40	$257.08	$437.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $121.75 / $145.74 / $162.94	Professional		$121.75	$145.74	$162.94