Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $265.13 / $651.84 / $17,930.00	Facility		$265.13	$651.84	$17,930.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.81 / $86.44 / $115.36	Facility	26	$49.81	$86.44	$115.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.13 / $239.87 / $443.59	Professional		$140.13	$239.87	$443.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.10 / $49.81 / $117.90	Professional	26	$40.10	$49.81	$117.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.17 / $188.01 / $326.67	Professional	TC	$98.17	$188.01	$326.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $261.26 / $261.26 / $261.26	Professional		$261.26	$261.26	$261.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $201.55 / $201.55 / $204.82	Professional	TC	$201.55	$201.55	$204.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $259.12 / $2,922.50	Facility		$55.00	$259.12	$2,922.50
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $52.55 / $155.16 / $181.86	Facility	26	$52.55	$155.16	$181.86
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $273.50 / $474.98 / $1,640.18	Professional		$273.50	$474.98	$1,640.18
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.04 / $97.23 / $907.84	Professional	26	$55.04	$97.23	$907.84
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $219.91 / $376.97 / $1,309.95	Professional	TC	$219.91	$376.97	$1,309.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.38 / $411.46 / $616.92	Professional		$145.38	$411.46	$616.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.51 / $81.09 / $117.88	Professional	26	$51.51	$81.09	$117.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.87 / $330.37 / $493.42	Professional	TC	$93.87	$330.37	$493.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.35 / $241.24 / $480.64	Facility		$138.35	$241.24	$480.64
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $47.15 / $84.10 / $109.69	Facility	26	$47.15	$84.10	$109.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.35 / $241.24 / $480.64	Professional		$138.35	$241.24	$480.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $49.23 / $84.10 / $109.39	Professional	26	$49.23	$84.10	$109.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $90.61 / $155.40 / $392.42	Professional	TC	$90.61	$155.40	$392.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.70 / $201.25 / $403.68	Professional		$34.70	$201.25	$403.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.27 / $273.82 / $379.89	Facility		$177.27	$273.82	$379.89
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $64.27 / $76.43 / $80.92	Facility	26	$64.27	$76.43	$80.92
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $46.40 / $63.21 / $83.08	Professional	26	$46.40	$63.21	$83.08
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $88.04 / $129.46 / $195.93	Professional	TC	$88.04	$129.46	$195.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $259.12 / $259.12 / $268.18	Facility		$259.12	$259.12	$268.18
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $52.55 / $52.55 / $53.47	Facility	26	$52.55	$52.55	$53.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.35 / $438.86 / $531.45	Professional		$269.35	$438.86	$531.45
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.04 / $89.19 / $109.66	Professional	26	$55.04	$89.19	$109.66
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $214.83 / $350.77 / $421.79	Professional	TC	$214.83	$350.77	$421.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $352.88 / $352.88 / $444.58	Facility		$352.88	$352.88	$444.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $273.50 / $372.74 / $502.08	Professional		$273.50	$372.74	$502.08
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $53.59 / $76.91 / $103.60	Professional	26	$53.59	$76.91	$103.60
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $219.91 / $295.83 / $398.48	Professional	TC	$219.91	$295.83	$398.48
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $193.62 / $366.81 / $558.05	Professional		$193.62	$366.81	$558.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.04 / $81.19 / $113.09	Professional	26	$51.04	$81.19	$113.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $130.65 / $253.55 / $445.09	Professional	TC	$130.65	$253.55	$445.09