Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.32 / $21.76 / $43.76	Facility	26	$13.32	$21.76	$43.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $52.27 / $104.54	Professional		$35.67	$52.27	$104.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.32 / $29.30	Professional	26	$10.23	$13.32	$29.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $38.95 / $69.65	Professional	TC	$25.05	$38.95	$69.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.24 / $81.63 / $82.55	Professional		$34.24	$81.63	$82.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.66 / $19.42 / $19.42	Professional	26	$6.66	$19.42	$19.42
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 $59.87 / $104.86 / $377.48	Professional		$59.87	$104.86	$377.48
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.17 / $28.87 / $96.83	Professional	26	$16.17	$28.87	$96.83
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.97 / $74.30 / $280.64	Professional	TC	$42.97	$74.30	$280.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $72.73 / $141.41	Professional		$39.29	$72.73	$141.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.54 / $21.99 / $35.56	Professional	26	$12.54	$21.99	$35.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.64 / $50.48 / $105.01	Professional	TC	$27.64	$50.48	$105.01
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $14.68 / $26.53 / $290.81	Facility	26	$14.68	$26.53	$290.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.51 / $79.61 / $115.21	Professional		$37.51	$79.61	$115.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.25 / $25.77 / $32.58	Professional	26	$13.25	$25.77	$32.58
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.35 / $54.02 / $85.64	Professional	TC	$26.35	$54.02	$85.64
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 $17.64 / $23.45 / $24.12	Facility	26	$17.64	$23.45	$24.12
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $43.92 / $43.92 / $43.92	Professional		$43.92	$43.92	$43.92
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $15.01 / $21.60 / $25.56	Professional	26	$15.01	$21.60	$25.56
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $33.29 / $46.90 / $57.49	Professional	TC	$33.29	$46.90	$57.49
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $15.86 / $15.86 / $16.00	Facility	26	$15.86	$15.86	$16.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.95 / $99.86 / $122.79	Professional		$63.95	$99.86	$122.79
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.04 / $27.09 / $33.31	Professional	26	$18.04	$27.09	$33.31
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.36 / $73.18 / $89.98	Professional	TC	$46.36	$73.18	$89.98
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $385.75	Facility	26	$211.40	$211.40	$385.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.52 / $89.74 / $118.15	Professional		$60.52	$89.74	$118.15
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $24.22 / $33.11	Professional	26	$16.80	$24.22	$33.11
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $44.35 / $65.30 / $88.72	Professional	TC	$44.35	$65.30	$88.72
United Facility/Professional Professional Modifier Low / Median / High Price $38.95 / $48.46 / $117.61	Professional		$38.95	$48.46	$117.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.62 / $15.50 / $40.20	Professional	26	$12.62	$15.50	$40.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.51 / $32.96 / $86.60	Professional	TC	$27.51	$32.96	$86.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.03 / $50.03 / $50.03	Professional		$50.03	$50.03	$50.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.66 / $12.66 / $12.66	Professional	26	$12.66	$12.66	$12.66
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $37.36 / $37.36 / $37.36	Professional	TC	$37.36	$37.36	$37.36