Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.03 / $87.21 / $359.56	Facility	26	$44.03	$87.21	$359.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.64 / $129.30 / $248.61	Professional		$92.64	$129.30	$248.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.20 / $85.27 / $140.57	Professional	TC	$57.20	$85.27	$140.57
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $180.13 / $180.13	Facility	26	$100.00	$180.13	$180.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $151.54 / $259.14 / $1,114.04	Professional		$151.54	$259.14	$1,114.04
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.48 / $168.89 / $909.46	Professional	TC	$97.48	$168.89	$909.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.63 / $211.71 / $351.38	Professional		$108.63	$211.71	$351.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.03 / $145.51 / $233.95	Professional	TC	$61.03	$145.51	$233.95
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $38.13 / $87.19 / $2,015.51	Facility	26	$38.13	$87.19	$2,015.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $110.76 / $206.86 / $356.28	Professional		$110.76	$206.86	$356.28
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $61.11 / $126.72 / $244.28	Professional	TC	$61.11	$126.72	$244.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.66 / $103.10 / $228.28	Professional		$21.66	$103.10	$228.28
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $59.78 / $77.72 / $79.06	Facility	26	$59.78	$77.72	$79.06
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $71.86 / $128.69 / $170.96	Professional	TC	$71.86	$128.69	$170.96
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $53.00 / $53.00 / $53.93	Facility	26	$53.00	$53.00	$53.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.60 / $257.14 / $311.30	Professional		$169.60	$257.14	$311.30
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $108.39 / $164.36 / $198.97	Professional	TC	$108.39	$164.36	$198.97
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,387.45 / $1,387.45 / $2,298.07	Facility	26	$1,387.45	$1,387.45	$2,298.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $151.54 / $224.00 / $295.83	Professional		$151.54	$224.00	$295.83
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $97.48 / $143.16 / $190.31	Professional	TC	$97.48	$143.16	$190.31
United Facility/Professional Professional Modifier Low / Median / High Price $104.66 / $147.15 / $299.04	Professional		$104.66	$147.15	$299.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.80 / $93.97 / $200.44	Professional	TC	$62.80	$93.97	$200.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $122.51 / $122.51 / $122.51	Professional		$122.51	$122.51	$122.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $80.78 / $80.78 / $80.78	Professional	TC	$80.78	$80.78	$80.78