Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.89 / $16.23 / $28.95	Facility	26	$9.89	$16.23	$28.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.85 / $38.64 / $82.95	Professional		$25.85	$38.64	$82.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $9.89 / $22.54	Professional	26	$7.33	$9.89	$22.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $59.24 / $59.24 / $149.21	Professional	50	$59.24	$59.24	$149.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $28.75 / $52.90	Professional	TC	$18.53	$28.75	$52.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.38 / $62.37 / $65.92	Professional		$54.38	$62.37	$65.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.99 / $15.03 / $34.97	Professional	26	$13.99	$15.03	$34.97
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $44.68 / $77.72 / $283.20	Professional		$44.68	$77.72	$283.20
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.01 / $20.23 / $82.56	Professional	26	$12.01	$20.23	$82.56
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $33.15 / $59.37 / $89.37	Professional	50	$33.15	$59.37	$89.37
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.41 / $56.09 / $213.75	Professional	TC	$30.41	$56.09	$213.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.85 / $52.87 / $105.73	Professional		$28.85	$52.87	$105.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $14.99 / $25.33	Professional	26	$8.34	$14.99	$25.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.74 / $38.38 / $79.79	Professional	TC	$20.74	$38.38	$79.79
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $18.36 / $236.39	Facility	26	$9.77	$18.36	$236.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.59 / $57.88 / $86.41	Professional		$27.59	$57.88	$86.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $17.64 / $22.41	Professional	26	$8.83	$17.64	$22.41
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $40.70 / $65.48	Professional	TC	$20.14	$40.70	$65.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.15 / $54.50 / $92.81	Professional		$9.15	$54.50	$92.81
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $12.25 / $16.07 / $16.75	Facility	26	$12.25	$16.07	$16.75
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $15.24 / $17.95	Professional	26	$10.80	$15.24	$17.95
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $25.97 / $36.00 / $48.72	Professional	TC	$25.97	$36.00	$48.72
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $11.43 / $11.43 / $11.78	Facility	26	$11.43	$11.43	$11.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.56 / $74.70 / $91.86	Professional		$49.56	$74.70	$91.86
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.08 / $19.46 / $23.80	Professional	26	$13.08	$19.46	$23.80
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.42 / $55.65 / $68.42	Professional	TC	$35.42	$55.65	$68.42
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $156.94 / $156.94 / $209.36	Facility	26	$156.94	$156.94	$209.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $44.83 / $67.13 / $88.02	Professional		$44.83	$67.13	$88.02
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.48 / $17.30 / $23.46	Professional	26	$12.48	$17.30	$23.46
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $49.55 / $66.86	Professional	TC	$32.79	$49.55	$66.86
United Facility/Professional Professional Modifier Low / Median / High Price $28.02 / $36.00 / $85.98	Professional		$28.02	$36.00	$85.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $9.98 / $26.38	Professional	26	$8.60	$9.98	$26.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.19 / $26.84 / $65.65	Professional	TC	$20.19	$26.84	$65.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $37.79 / $37.79	Professional		$37.79	$37.79	$37.79
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $9.11 / $9.11	Professional	26	$9.11	$9.11	$9.11
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $28.69 / $28.69 / $28.69	Professional	TC	$28.69	$28.69	$28.69