Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.11 / $18.12 / $36.64	Facility	26	$11.11	$18.12	$36.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.68 / $38.58 / $78.44	Professional		$26.68	$38.58	$78.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.19 / $11.11 / $24.62	Professional	26	$8.19	$11.11	$24.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $27.19 / $52.39	Professional	TC	$18.48	$27.19	$52.39
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 $44.35 / $77.25 / $277.13	Professional		$44.35	$77.25	$277.13
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.40 / $23.26 / $78.44	Professional	26	$13.40	$23.26	$78.44
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.95 / $53.62 / $199.20	Professional	TC	$30.95	$53.62	$199.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.72 / $56.58 / $103.34	Professional		$29.72	$56.58	$103.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $17.73 / $28.43	Professional	26	$10.10	$17.73	$28.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.74 / $37.99 / $75.52	Professional	TC	$20.74	$37.99	$75.52
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $9.92 / $21.12 / $236.39	Facility	26	$9.92	$21.12	$236.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.41 / $60.53 / $85.65	Professional		$29.41	$60.53	$85.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.92 / $20.17 / $26.48	Professional	26	$9.92	$20.17	$26.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.53 / $40.90 / $62.15	Professional	TC	$19.53	$40.90	$62.15
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 $14.70 / $18.76 / $19.72	Facility	26	$14.70	$18.76	$19.72
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $11.81 / $17.11 / $20.30	Professional	26	$11.81	$17.11	$20.30
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $34.45 / $42.18	Professional	TC	$23.72	$34.45	$42.18
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $12.80 / $12.80 / $13.14	Facility	26	$12.80	$12.80	$13.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.83 / $73.81 / $89.98	Professional		$49.83	$73.81	$89.98
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.95 / $22.02 / $26.66	Professional	26	$14.95	$22.02	$26.66
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.93 / $51.74 / $63.74	Professional	TC	$34.93	$51.74	$63.74
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 $44.85 / $65.76 / $86.59	Professional		$44.85	$65.76	$86.59
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.92 / $19.38 / $27.59	Professional	26	$13.92	$19.38	$27.59
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $30.95 / $46.58 / $63.09	Professional	TC	$30.95	$46.58	$63.09
United Facility/Professional Professional Modifier Low / Median / High Price $29.92 / $36.15 / $88.43	Professional		$29.92	$36.15	$88.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $11.46 / $28.67	Professional	26	$9.86	$11.46	$28.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.19 / $25.34 / $64.59	Professional	TC	$20.19	$25.34	$64.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.56 / $36.56 / $36.56	Professional		$36.56	$36.56	$36.56
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $10.24 / $10.24	Professional	26	$10.24	$10.24	$10.24
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.32 / $26.32 / $26.32	Professional	TC	$26.32	$26.32	$26.32