Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $11.93 / $39.45 / $65.18	Facility		$11.93	$39.45	$65.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.78 / $36.78 / $229.47	Facility	26	$36.78	$36.78	$229.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.66 / $39.45 / $77.23	Professional		$15.66	$39.45	$77.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.66 / $36.78 / $71.63	Professional	26	$15.66	$36.78	$71.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.00 / $25.00 / $25.00	Professional	26	$25.00	$25.00	$25.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $67.18 / $105.36 / $242.00	Facility		$67.18	$105.36	$242.00
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $60.25 / $223.26 / $223.26	Facility	26	$60.25	$223.26	$223.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $65.59 / $117.41 / $408.15	Professional		$65.59	$117.41	$408.15
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.47 / $109.24 / $377.78	Professional	26	$52.47	$109.24	$377.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3.41 / $7.27 / $27.50	Facility		$3.41	$7.27	$27.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.67 / $9.27 / $17.01	Facility	26	$8.67	$9.27	$17.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $43.45 / $43.45	Professional		$43.45	$43.45	$43.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $40.47 / $40.47	Professional	26	$40.47	$40.47	$40.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $27.84 / $74.80 / $126.91	Facility		$27.84	$74.80	$126.91
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $17.05 / $34.20 / $113.70	Facility	26	$17.05	$34.20	$113.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.04 / $77.90 / $129.10	Professional		$29.04	$77.90	$129.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $43.03 / $119.19	Professional	26	$17.05	$43.03	$119.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.60 / $73.20 / $163.81	Professional		$15.60	$73.20	$163.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.16 / $96.86 / $98.49	Facility		$68.16	$96.86	$98.49
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $29.64 / $75.81 / $91.79	Facility	26	$29.64	$75.81	$91.79
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $21.94 / $39.52 / $91.79	Professional	26	$21.94	$39.52	$91.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.33 / $64.33 / $67.18	Facility		$64.33	$64.33	$67.18
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $60.25 / $60.25 / $62.61	Facility	26	$60.25	$60.25	$62.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.50 / $111.85 / $135.00	Professional		$68.50	$111.85	$135.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.61 / $104.39 / $126.74	Professional	26	$62.61	$104.39	$126.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $65.59 / $95.62 / $122.01	Professional		$65.59	$95.62	$122.01
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $52.47 / $89.11 / $114.54	Professional	26	$52.47	$89.11	$114.54
United Facility/Professional Professional Modifier Low / Median / High Price $22.27 / $33.40 / $139.63	Professional		$22.27	$33.40	$139.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.14 / $32.07 / $133.22	Professional	26	$20.14	$32.07	$133.22