Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $19.14 / $36.70	Professional		$14.00	$19.14	$36.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.70 / $10.74 / $18.13	Professional	TC	$6.70	$10.74	$18.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $38.86 / $206.87	Professional		$21.88	$38.86	$206.87
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.81 / $20.57 / $125.44	Professional	TC	$11.81	$20.57	$125.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.20 / $33.33 / $52.61	Professional		$19.20	$33.33	$52.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.90 / $17.02 / $28.74	Professional	TC	$9.90	$17.02	$28.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $39.34 / $49.98	Professional		$20.14	$39.34	$49.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $10.63 / $20.37 / $28.36	Professional	TC	$10.63	$20.37	$28.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.05 / $5.55 / $11.51	Professional		$5.05	$5.55	$11.51
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $13.75 / $16.75 / $16.75	Professional		$13.75	$16.75	$16.75
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $11.96 / $16.20 / $21.20	Professional	TC	$11.96	$16.20	$21.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.91 / $34.85 / $45.36	Professional		$15.91	$34.85	$45.36
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.02 / $19.00 / $23.80	Professional	TC	$13.02	$19.00	$23.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $23.57 / $34.25 / $50.00	Professional		$23.57	$34.25	$50.00
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $11.29 / $16.51 / $24.41	Professional	TC	$11.29	$16.51	$24.41
United Facility/Professional Professional Modifier Low / Median / High Price $17.68 / $23.76 / $46.54	Professional		$17.68	$23.76	$46.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.30 / $11.95 / $22.79	Professional	TC	$8.30	$11.95	$22.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.70 / $19.70 / $19.70	Professional		$19.70	$19.70	$19.70
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.54 / $10.54 / $10.54	Professional	TC	$10.54	$10.54	$10.54