Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.32 / $21.76 / $37.54	Facility	26	$13.32	$21.76	$37.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.20 / $49.57 / $107.08	Professional		$38.20	$49.57	$107.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $12.21 / $26.11	Professional	26	$9.41	$12.21	$26.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.76 / $38.59 / $76.98	Professional	TC	$27.76	$38.59	$76.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.02 / $35.02 / $102.42	Professional		$35.02	$35.02	$102.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.86 / $18.86 / $18.86	Professional	26	$18.86	$18.86	$18.86
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $103.00 / $103.00	Facility	26	$100.00	$103.00	$103.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $60.23 / $106.46 / $386.25	Professional		$60.23	$106.46	$386.25
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.17 / $26.95 / $107.32	Professional	26	$16.17	$26.95	$107.32
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.28 / $78.19 / $289.43	Professional	TC	$45.28	$78.19	$289.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.11 / $78.79 / $144.76	Professional		$43.11	$78.79	$144.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.12 / $19.85 / $35.56	Professional	26	$11.12	$19.85	$35.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.85 / $59.56 / $110.10	Professional	TC	$31.85	$59.56	$110.10
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $12.71 / $23.72 / $290.81	Facility	26	$12.71	$23.72	$290.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $84.94 / $118.24	Professional		$41.85	$84.94	$118.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.41 / $22.74 / $30.01	Professional	26	$11.41	$22.74	$30.01
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.24 / $61.22 / $89.44	Professional	TC	$32.24	$61.22	$89.44
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 $15.68 / $21.39 / $23.45	Facility	26	$15.68	$21.39	$23.45
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $12.77 / $18.60 / $23.64	Professional	26	$12.77	$18.60	$23.64
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $37.13 / $51.86 / $66.19	Professional	TC	$37.13	$51.86	$66.19
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $15.86 / $15.86 / $16.00	Facility	26	$15.86	$15.86	$16.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $102.10 / $125.60	Professional		$68.56	$102.10	$125.60
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $27.09 / $32.81	Professional	26	$17.98	$27.09	$32.81
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.52 / $75.47 / $92.79	Professional	TC	$50.52	$75.47	$92.79
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 $61.45 / $91.79 / $120.36	Professional		$61.45	$91.79	$120.36
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.43 / $24.05 / $32.69	Professional	26	$16.43	$24.05	$32.69
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $45.28 / $67.81 / $91.52	Professional	TC	$45.28	$67.81	$91.52
United Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $49.61 / $121.26	Professional		$43.67	$49.61	$121.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.18 / $13.98 / $34.59	Professional	26	$11.18	$13.98	$34.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.04 / $36.53 / $93.10	Professional	TC	$31.04	$36.53	$93.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.21 / $51.21 / $51.21	Professional		$51.21	$51.21	$51.21
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.26 / $12.26 / $12.26	Professional	26	$12.26	$12.26	$12.26
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $38.95 / $38.95 / $38.95	Professional	TC	$38.95	$38.95	$38.95