Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $21.57 / $38.67	Facility	26	$11.48	$21.57	$38.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.05 / $21.53 / $36.22	Professional		$16.05	$21.53	$36.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $10.70 / $21.67	Professional	26	$8.66	$10.70	$21.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.27 / $10.84 / $16.60	Professional	TC	$7.27	$10.84	$16.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.46 / $17.46 / $17.46	Professional	26	$17.46	$17.46	$17.46
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 $24.49 / $45.05 / $206.87	Professional		$24.49	$45.05	$206.87
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.40 / $23.47 / $105.66	Professional	26	$13.40	$23.47	$105.66
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.82 / $20.84 / $129.58	Professional	TC	$11.82	$20.84	$129.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.85 / $36.14 / $57.73	Professional		$21.85	$36.14	$57.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.92 / $18.85 / $29.45	Professional	26	$10.92	$18.85	$29.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.18 / $17.57 / $29.97	Professional	TC	$10.18	$17.57	$29.97
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $11.82 / $22.38 / $236.39	Facility	26	$11.82	$22.38	$236.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $20.32 / $41.54 / $54.84	Professional		$20.32	$41.54	$54.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.88 / $21.77 / $28.17	Professional	26	$10.88	$21.77	$28.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $9.69 / $20.39 / $29.10	Professional	TC	$9.69	$20.39	$29.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.60 / $6.16 / $12.33	Professional		$5.60	$6.16	$12.33
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $15.95 / $19.43 / $21.08	Facility	26	$15.95	$19.43	$21.08
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $14.05 / $18.39 / $21.76	Professional	26	$14.05	$18.39	$21.76
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $12.48 / $16.23 / $20.22	Professional	TC	$12.48	$16.23	$20.22
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $13.14 / $13.14 / $13.25	Facility	26	$13.14	$13.14	$13.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.87 / $42.54 / $51.57	Professional		$27.87	$42.54	$51.57
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.95 / $22.45 / $27.61	Professional	26	$14.95	$22.45	$27.61
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.06 / $19.73 / $24.37	Professional	TC	$13.06	$19.73	$24.37
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 $26.02 / $37.68 / $51.61	Professional		$26.02	$37.68	$51.61
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.92 / $20.07 / $29.43	Professional	26	$13.92	$20.07	$29.43
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $11.78 / $17.14 / $24.83	Professional	TC	$11.78	$17.14	$24.83
United Facility/Professional Professional Modifier Low / Median / High Price $19.48 / $24.13 / $53.37	Professional		$19.48	$24.13	$53.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.70 / $11.67 / $27.56	Professional	26	$10.70	$11.67	$27.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.66 / $11.76 / $23.74	Professional	TC	$8.66	$11.76	$23.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.11 / $21.11 / $21.11	Professional		$21.11	$21.11	$21.11
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $10.58 / $10.58	Professional	26	$10.58	$10.58	$10.58
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.54 / $10.54 / $10.54	Professional	TC	$10.54	$10.54	$10.54