Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.49 / $12.27 / $26.27	Professional	26	$8.49	$12.27	$26.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.48 / $34.27 / $66.69	Professional	TC	$21.48	$34.27	$66.69
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.78 / $26.25 / $89.10	Professional	26	$14.78	$26.25	$89.10
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.88 / $64.26 / $300.00	Professional	TC	$37.88	$64.26	$300.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $19.26 / $32.54	Professional	26	$11.14	$19.26	$32.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.67 / $46.55 / $90.02	Professional	TC	$24.67	$46.55	$90.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.54 / $22.38 / $29.53	Professional	26	$10.54	$22.38	$29.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.80 / $50.75 / $73.52	Professional	TC	$24.80	$50.75	$73.52
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $13.95 / $18.32 / $24.00	Professional	26	$13.95	$18.32	$24.00
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $31.96 / $43.28 / $52.62	Professional	TC	$31.96	$43.28	$52.62
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.81 / $24.39 / $29.99	Professional	26	$15.81	$24.39	$29.99
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.61 / $62.69 / $75.92	Professional	TC	$41.61	$62.69	$75.92
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.36 / $22.02 / $29.88	Professional	26	$15.36	$22.02	$29.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $37.88 / $55.66 / $75.65	Professional	TC	$37.88	$55.66	$75.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.69 / $12.71 / $30.39	Professional	26	$10.69	$12.71	$30.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.84 / $31.16 / $76.95	Professional	TC	$25.84	$31.16	$76.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.31 / $11.31 / $11.31	Professional	26	$11.31	$11.31	$11.31
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.45 / $31.45 / $31.45	Professional	TC	$31.45	$31.45	$31.45