Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.15 / $11.85 / $23.49	Facility	26	$9.15	$11.85	$23.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.48 / $38.90 / $100.43	Professional		$24.48	$38.90	$100.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $10.00 / $24.86	Professional	26	$7.03	$10.00	$24.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $99.72 / $99.89 / $102.21	Professional	50	$99.72	$99.89	$102.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $29.60 / $52.90	Professional	TC	$18.82	$29.60	$52.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.86 / $69.41 / $85.32	Professional		$53.86	$69.41	$85.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $13.50 / $21.52	Professional	26	$8.56	$13.50	$21.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $53.80 / $53.80 / $53.80	Professional	TC	$53.80	$53.80	$53.80
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 $44.35 / $76.95 / $283.73	Professional		$44.35	$76.95	$283.73
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $18.72 / $79.26	Professional	26	$11.09	$18.72	$79.26
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $42.41 / $63.26 / $104.38	Professional	50	$42.41	$63.26	$104.38
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.26 / $56.44 / $216.60	Professional	TC	$33.26	$56.44	$216.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.88 / $54.27 / $106.06	Professional		$28.88	$54.27	$106.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.35 / $14.52 / $24.35	Professional	26	$8.35	$14.52	$24.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.07 / $38.90 / $80.89	Professional	TC	$21.07	$38.90	$80.89
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $9.38 / $18.19 / $236.39	Facility	26	$9.38	$18.19	$236.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.59 / $57.42 / $86.41	Professional		$27.59	$57.42	$86.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $17.43 / $22.29	Professional	26	$8.61	$17.43	$22.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $39.97 / $65.48	Professional	TC	$20.14	$39.97	$65.48
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 $11.76 / $15.78 / $16.07	Facility	26	$11.76	$15.78	$16.07
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $9.60 / $14.16 / $17.55	Professional	26	$9.60	$14.16	$17.55
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $34.56 / $49.58	Professional	TC	$23.72	$34.56	$49.58
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $10.87 / $10.87 / $10.97	Facility	26	$10.87	$10.87	$10.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.71 / $74.70 / $91.86	Professional		$47.71	$74.70	$91.86
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.37 / $18.57 / $22.84	Professional	26	$12.37	$18.57	$22.84
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.15 / $56.41 / $69.36	Professional	TC	$36.15	$56.41	$69.36
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 $44.83 / $67.00 / $88.02	Professional		$44.83	$67.00	$88.02
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.52 / $16.52 / $22.41	Professional	26	$11.52	$16.52	$22.41
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $33.26 / $50.25 / $67.80	Professional	TC	$33.26	$50.25	$67.80
United Facility/Professional Professional Modifier Low / Median / High Price $29.36 / $36.15 / $88.43	Professional		$29.36	$36.15	$88.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $9.52 / $23.11	Professional	26	$8.30	$9.52	$23.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.20 / $26.49 / $63.26	Professional	TC	$21.20	$26.49	$63.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.52 / $37.52 / $37.52	Professional		$37.52	$37.52	$37.52
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $8.44 / $8.44	Professional	26	$8.44	$8.44	$8.44
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Professional	TC	$29.08	$29.08	$29.08