Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.89 / $10.78 / $23.12	Facility	26	$9.89	$10.78	$23.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $37.79 / $94.50	Professional		$24.92	$37.79	$94.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $10.25 / $27.89	Professional	26	$7.33	$10.25	$27.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $27.90 / $52.47	Professional	TC	$17.57	$27.90	$52.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.68 / $51.61 / $51.61	Professional		$24.68	$51.61	$51.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.78 / $13.99 / $15.03	Professional	26	$6.78	$13.99	$15.03
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 $42.96 / $75.36 / $271.58	Professional		$42.96	$75.36	$271.58
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.01 / $20.14 / $111.75	Professional	26	$12.01	$20.14	$111.75
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.97 / $54.01 / $199.20	Professional	TC	$29.97	$54.01	$199.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.05 / $51.99 / $101.27	Professional		$28.05	$51.99	$101.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $15.28 / $26.37	Professional	26	$8.57	$15.28	$26.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.71 / $36.52 / $75.52	Professional	TC	$19.71	$36.52	$75.52
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $18.36 / $236.39	Facility	26	$9.77	$18.36	$236.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.84 / $56.33 / $84.13	Professional		$27.84	$56.33	$84.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $17.64 / $22.41	Professional	26	$8.83	$17.64	$22.41
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.88 / $39.50 / $61.67	Professional	TC	$19.88	$39.50	$61.67
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 $13.68 / $16.55 / $17.42	Facility	26	$13.68	$16.55	$17.42
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.08 / $14.50 / $17.95	Professional	26	$10.08	$14.50	$17.95
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $33.63 / $45.36	Professional	TC	$24.12	$33.63	$45.36
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $11.78 / $11.78 / $11.88	Facility	26	$11.78	$11.78	$11.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.79 / $72.29 / $88.11	Professional		$46.79	$72.29	$88.11
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.40 / $20.12 / $24.37	Professional	26	$13.40	$20.12	$24.37
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.67 / $51.84 / $63.74	Professional	TC	$33.67	$51.84	$63.74
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 $43.92 / $64.39 / $84.78	Professional		$43.92	$64.39	$84.78
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.48 / $17.86 / $24.28	Professional	26	$12.48	$17.86	$24.28
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $31.42 / $46.58 / $63.81	Professional	TC	$31.42	$46.58	$63.81
United Facility/Professional Professional Modifier Low / Median / High Price $28.29 / $35.40 / $85.00	Professional		$28.29	$35.40	$85.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $10.27 / $25.69	Professional	26	$8.66	$10.27	$25.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.70 / $25.72 / $62.90	Professional	TC	$19.70	$25.72	$62.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.83 / $35.83 / $35.83	Professional		$35.83	$35.83	$35.83
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $9.11 / $9.11	Professional	26	$9.11	$9.11	$9.11
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.72 / $26.72 / $26.72	Professional	TC	$26.72	$26.72	$26.72