Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.64 / $25.53 / $47.46	Facility	26	$15.64	$25.53	$47.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $52.47 / $103.47	Professional		$36.88	$52.47	$103.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $15.64 / $31.28	Professional	26	$11.50	$15.64	$31.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $36.82 / $65.90	Professional	TC	$25.37	$36.82	$65.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.25 / $34.25 / $34.25	Professional		$34.25	$34.25	$34.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.76 / $23.76 / $23.76	Professional	26	$23.76	$23.76	$23.76
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 $60.32 / $105.83 / $379.35	Professional		$60.32	$105.83	$379.35
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.94 / $32.99 / $113.25	Professional	26	$18.94	$32.99	$113.25
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.58 / $71.75 / $266.10	Professional	TC	$41.58	$71.75	$266.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.18 / $75.25 / $141.88	Professional		$40.18	$75.25	$141.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.07 / $24.83 / $41.71	Professional	26	$14.07	$24.83	$41.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.81 / $50.78 / $99.53	Professional	TC	$26.81	$50.78	$99.53
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $13.64 / $29.57 / $290.81	Facility	26	$13.64	$29.57	$290.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.42 / $81.88 / $116.73	Professional		$39.42	$81.88	$116.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $27.78 / $37.72	Professional	26	$13.64	$27.78	$37.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.35 / $55.10 / $82.62	Professional	TC	$26.35	$55.10	$82.62
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 $22.23 / $26.52 / $27.88	Facility	26	$22.23	$26.52	$27.88
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $17.94 / $23.01 / $29.19	Professional	26	$17.94	$23.01	$29.19
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $33.67 / $46.02 / $59.23	Professional	TC	$33.67	$46.02	$59.23
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $18.57 / $18.57 / $18.73	Facility	26	$18.57	$18.57	$18.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.05 / $100.62 / $123.72	Professional		$68.05	$100.62	$123.72
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.06 / $31.73 / $38.43	Professional	26	$21.06	$31.73	$38.43
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.75 / $69.37 / $85.29	Professional	TC	$46.75	$69.37	$85.29
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $385.75	Facility	26	$211.40	$211.40	$385.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.52 / $90.42 / $118.56	Professional		$60.52	$90.42	$118.56
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $19.68 / $28.21 / $38.63	Professional	26	$19.68	$28.21	$38.63
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $41.58 / $62.34 / $84.75	Professional	TC	$41.58	$62.34	$84.75
United Facility/Professional Professional Modifier Low / Median / High Price $40.50 / $49.20 / $119.58	Professional		$40.50	$49.20	$119.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.89 / $16.68 / $39.36	Professional	26	$13.89	$16.68	$39.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.86 / $33.92 / $78.83	Professional	TC	$27.86	$33.92	$78.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $49.80 / $49.80 / $49.80	Professional		$49.80	$49.80	$49.80
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $14.40 / $14.40	Professional	26	$14.40	$14.40	$14.40
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Professional	TC	$35.40	$35.40	$35.40