Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.35 / $10.91 / $24.21	Facility	26	$8.35	$10.91	$24.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.26 / $31.51 / $143.76	Facility	TC	$17.26	$31.51	$143.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.57 / $25.94 / $54.70	Professional		$19.57	$25.94	$54.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $8.36 / $18.66	Professional	26	$6.42	$8.36	$18.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.09 / $17.57 / $35.14	Professional	TC	$13.09	$17.57	$35.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $17.19 / $21.57	Professional		$15.69	$17.19	$21.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $11.46 / $13.39	Professional	26	$5.89	$11.46	$13.39
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 Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	TC	$100.00	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $29.57 / $51.80 / $187.88	Professional		$29.57	$51.80	$187.88
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $17.28 / $72.64	Professional	26	$10.16	$17.28	$72.64
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $28.35 / $43.65 / $80.70	Professional	50	$28.35	$43.65	$80.70
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.39 / $34.50 / $148.00	Professional	TC	$19.39	$34.50	$148.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.32 / $40.63 / $69.41	Professional		$23.32	$40.63	$69.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $13.57 / $22.29	Professional	26	$7.86	$13.57	$22.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.31 / $27.03 / $47.63	Professional	TC	$15.31	$27.03	$47.63
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $7.44 / $16.67 / $236.39	Facility	26	$7.44	$16.67	$236.39
Kaiser Permanente Facility/Professional Facility Modifier TC Low / Median / High Price $15.50 / $32.77 / $236.39	Facility	TC	$15.50	$32.77	$236.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.52 / $47.12 / $61.84	Professional		$22.52	$47.12	$61.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $16.16 / $20.30	Professional	26	$7.44	$16.16	$20.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $15.50 / $31.64 / $43.04	Professional	TC	$15.50	$31.64	$43.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Professional		$70.00	$70.00	$70.00
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $12.09 / $14.44 / $14.96	Facility	26	$12.09	$14.44	$14.96
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $23.64 / $28.14 / $28.81	Facility	TC	$23.64	$28.14	$28.81
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $9.18 / $12.98 / $16.34	Professional	26	$9.18	$12.98	$16.34
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $25.20 / $31.75	Professional	TC	$18.48	$25.20	$31.75
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $9.97 / $9.97 / $10.05	Facility	26	$9.97	$9.97	$10.05
Premera BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $19.03 / $19.03 / $19.64	Facility	TC	$19.03	$19.03	$19.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $49.55 / $60.92	Professional		$33.54	$49.55	$60.92
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.34 / $17.03 / $20.62	Professional	26	$11.34	$17.03	$20.62
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.20 / $33.28 / $40.29	Professional	TC	$22.20	$33.28	$40.29
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 Facility Modifier TC Low / Median / High Price $156.94 / $156.94 / $209.36	Facility	TC	$156.94	$156.94	$209.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $44.73 / $59.78	Professional		$31.42	$44.73	$59.78
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.56 / $15.14 / $21.15	Professional	26	$10.56	$15.14	$21.15
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $20.16 / $29.46 / $39.54	Professional	TC	$20.16	$29.46	$39.54
United Facility/Professional Professional Modifier Low / Median / High Price $21.65 / $26.68 / $59.28	Professional		$21.65	$26.68	$59.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $8.76 / $21.04	Professional	26	$7.74	$8.76	$21.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.71 / $17.01 / $37.54	Professional	TC	$13.71	$17.01	$37.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Professional		$24.55	$24.55	$24.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.70 / $7.70 / $7.70	Professional	26	$7.70	$7.70	$7.70
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.85 / $16.85 / $16.85	Professional	TC	$16.85	$16.85	$16.85