Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.51 / $14.27 / $30.30	Facility	26	$9.51	$14.27	$30.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.45 / $38.69 / $87.82	Professional		$27.45	$38.69	$87.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $9.52 / $20.21	Professional	26	$7.30	$9.52	$20.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.16 / $29.17 / $54.75	Professional	TC	$20.16	$29.17	$54.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.46 / $60.40 / $60.40	Professional		$25.46	$60.40	$60.40
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 $44.81 / $77.72 / $280.50	Professional		$44.81	$77.72	$280.50
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $20.23 / $69.68	Professional	26	$11.55	$20.23	$69.68
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.26 / $57.00 / $210.83	Professional	TC	$33.26	$57.00	$210.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.70 / $56.85 / $104.78	Professional		$29.70	$56.85	$104.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $15.12 / $25.36	Professional	26	$8.69	$15.12	$25.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.20 / $40.84 / $79.98	Professional	TC	$22.20	$40.84	$79.98
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 $29.45 / $61.13 / $85.65	Professional		$29.45	$61.13	$85.65
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 $21.70 / $43.84 / $65.94	Professional	TC	$21.70	$43.84	$65.94
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 $12.74 / $16.45 / $16.75	Facility	26	$12.74	$16.45	$16.75
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.05 / $15.08 / $17.62	Professional	26	$10.05	$15.08	$17.62
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $26.05 / $37.11 / $46.61	Professional	TC	$26.05	$37.11	$46.61
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $11.33 / $11.33 / $11.43	Facility	26	$11.33	$11.33	$11.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.83 / $73.94 / $90.92	Professional		$49.83	$73.94	$90.92
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.89 / $19.35 / $23.43	Professional	26	$12.89	$19.35	$23.43
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.97 / $54.89 / $67.48	Professional	TC	$35.97	$54.89	$67.48
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 $45.32 / $66.44 / $87.49	Professional		$45.32	$66.44	$87.49
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $17.20 / $23.35	Professional	26	$12.00	$17.20	$23.35
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $33.26 / $49.32 / $67.23	Professional	TC	$33.26	$49.32	$67.23
United Facility/Professional Professional Modifier Low / Median / High Price $31.22 / $36.15 / $88.43	Professional		$31.22	$36.15	$88.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $9.92 / $23.75	Professional	26	$8.66	$9.92	$23.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.96 / $25.42 / $62.37	Professional	TC	$21.96	$25.42	$62.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $37.07 / $37.07	Professional		$37.07	$37.07	$37.07
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 $28.29 / $28.29 / $28.29	Professional	TC	$28.29	$28.29	$28.29