Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.73 / $14.26 / $26.60	Facility	26	$8.73	$14.26	$26.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.02 / $28.75 / $57.32	Professional		$21.02	$28.75	$57.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $8.73 / $20.67	Professional	26	$6.71	$8.73	$20.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.31 / $19.72 / $38.60	Professional	TC	$14.31	$19.72	$38.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.62 / $45.62 / $51.15	Professional		$45.62	$45.62	$51.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.30 / $12.86 / $13.27	Professional	26	$4.30	$12.86	$13.27
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 $33.72 / $58.70 / $542.00	Professional		$33.72	$58.70	$542.00
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.63 / $18.41 / $64.13	Professional	26	$10.63	$18.41	$64.13
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.10 / $40.33 / $498.00	Professional	TC	$23.10	$40.33	$498.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.38 / $43.34 / $78.17	Professional		$23.38	$43.34	$78.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $13.78 / $23.30	Professional	26	$7.65	$13.78	$23.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.32 / $28.55 / $55.44	Professional	TC	$15.32	$28.55	$55.44
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $8.97 / $16.82 / $236.39	Facility	26	$8.97	$16.82	$236.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.01 / $46.71 / $65.18	Professional		$22.01	$46.71	$65.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $16.23 / $20.62	Professional	26	$8.10	$16.23	$20.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $15.19 / $31.37 / $46.23	Professional	TC	$15.19	$31.37	$46.23
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 $11.27 / $14.74 / $15.41	Facility	26	$11.27	$14.74	$15.41
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $13.20 / $16.21	Professional	26	$10.02	$13.20	$16.21
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $18.89 / $26.40 / $34.53	Professional	TC	$18.89	$26.40	$34.53
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $10.42 / $10.42 / $10.51	Facility	26	$10.42	$10.42	$10.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.00 / $56.51 / $68.42	Professional		$37.00	$56.51	$68.42
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.82 / $17.80 / $21.56	Professional	26	$11.82	$17.80	$21.56
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.09 / $38.47 / $46.87	Professional	TC	$25.09	$38.47	$46.87
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 $34.11 / $50.01 / $65.84	Professional		$34.11	$50.01	$65.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $15.83 / $21.48	Professional	26	$11.04	$15.83	$21.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $23.10 / $34.25 / $46.92	Professional	TC	$23.10	$34.25	$46.92
United Facility/Professional Professional Modifier Low / Median / High Price $23.60 / $27.59 / $67.48	Professional		$23.60	$27.59	$67.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.88 / $9.13 / $21.84	Professional	26	$7.88	$9.13	$21.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.76 / $18.77 / $44.47	Professional	TC	$15.76	$18.77	$44.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.65 / $27.65 / $27.65	Professional		$27.65	$27.65	$27.65
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.03 / $8.03 / $8.03	Professional	26	$8.03	$8.03	$8.03
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.61 / $19.61 / $19.61	Professional	TC	$19.61	$19.61	$19.61