Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.51 / $11.55 / $23.49	Facility	26	$9.51	$11.55	$23.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.89 / $45.92 / $104.79	Professional		$29.89	$45.92	$104.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $9.52 / $23.85	Professional	26	$7.33	$9.52	$23.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $36.39 / $64.45	Professional	TC	$22.57	$36.39	$64.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.59 / $70.45 / $70.45	Professional		$29.59	$70.45	$70.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.67 / $13.45 / $13.45	Professional	26	$4.67	$13.45	$13.45
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 $50.00 / $91.35 / $327.08	Professional		$50.00	$91.35	$327.08
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $20.14 / $66.83	Professional	26	$11.55	$20.14	$66.83
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.18 / $69.42 / $260.33	Professional	TC	$39.18	$69.42	$260.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.28 / $60.90 / $122.63	Professional		$33.28	$60.90	$122.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $15.11 / $24.31	Professional	26	$8.69	$15.11	$24.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.59 / $46.80 / $97.55	Professional	TC	$25.59	$46.80	$97.55
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $18.95 / $236.39	Facility	26	$9.77	$18.95	$236.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.54 / $67.15 / $102.33	Professional		$32.54	$67.15	$102.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $18.19 / $23.15	Professional	26	$9.00	$18.19	$23.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.40 / $48.76 / $80.25	Professional	TC	$24.40	$48.76	$80.25
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 $10.05 / $14.50 / $17.63	Professional	26	$10.05	$14.50	$17.63
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $31.49 / $42.34 / $59.47	Professional	TC	$31.49	$42.34	$59.47
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $10.97 / $10.97 / $11.33	Facility	26	$10.97	$10.97	$11.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.57 / $87.46 / $105.91	Professional		$56.57	$87.46	$105.91
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.91 / $18.87 / $22.85	Professional	26	$12.91	$18.87	$22.85
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.92 / $67.84 / $83.42	Professional	TC	$43.92	$67.84	$83.42
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 $52.67 / $77.40 / $102.82	Professional		$52.67	$77.40	$102.82
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $16.69 / $22.99	Professional	26	$12.00	$16.69	$22.99
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $41.12 / $60.97 / $83.52	Professional	TC	$41.12	$60.97	$83.52
United Facility/Professional Professional Modifier Low / Median / High Price $32.70 / $42.87 / $104.84	Professional		$32.70	$42.87	$104.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $10.38 / $24.70	Professional	26	$8.66	$10.38	$24.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.65 / $32.56 / $82.05	Professional	TC	$24.65	$32.56	$82.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.38 / $43.38 / $43.38	Professional		$43.38	$43.38	$43.38
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $8.77 / $8.77	Professional	26	$8.77	$8.77	$8.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.61 / $34.61 / $34.61	Professional	TC	$34.61	$34.61	$34.61