Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.31 / $16.76 / $36.51	Facility	26	$10.31	$16.76	$36.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $39.51 / $81.90	Professional		$27.54	$39.51	$81.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $10.48 / $24.44	Professional	26	$8.30	$10.48	$24.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.81 / $16.98 / $37.03	Professional	52	$11.81	$16.98	$37.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.39 / $28.39 / $58.27	Professional	TC	$19.39	$28.39	$58.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.54 / $14.54 / $14.54	Professional	26	$14.54	$14.54	$14.54
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 $40.08 / $71.38 / $251.18	Professional		$40.08	$71.38	$251.18
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.47 / $21.85 / $79.26	Professional	26	$12.47	$21.85	$79.26
Asuris Northwest Health Facility/Professional Professional Modifier 52 Low / Median / High Price $17.87 / $17.87 / $17.87	Professional	52	$17.87	$17.87	$17.87
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.49 / $49.03 / $205.00	Professional	TC	$28.49	$49.03	$205.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.21 / $60.04 / $93.92	Professional		$35.21	$60.04	$93.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $17.72 / $27.42	Professional	26	$10.18	$17.72	$27.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.21 / $42.10 / $66.92	Professional	TC	$24.21	$42.10	$66.92
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $9.92 / $21.22 / $236.39	Facility	26	$9.92	$21.22	$236.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.27 / $71.81 / $93.75	Professional		$38.27	$71.81	$93.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.01 / $20.92 / $26.48	Professional	26	$10.01	$20.92	$26.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.01 / $50.61 / $67.02	Professional	TC	$27.01	$50.61	$67.02
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 $14.84 / $17.78 / $20.10	Facility	26	$14.84	$17.78	$20.10
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $12.06 / $17.39 / $21.12	Professional	26	$12.06	$17.39	$21.12
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $40.86 / $53.25	Professional	TC	$28.14	$40.86	$53.25
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $12.23 / $12.23 / $12.34	Facility	26	$12.23	$12.23	$12.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.39 / $67.34 / $81.93	Professional		$44.39	$67.34	$81.93
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.92 / $21.19 / $25.31	Professional	26	$13.92	$21.19	$25.31
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.46 / $46.44 / $57.12	Professional	TC	$30.46	$46.44	$57.12
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 $41.74 / $59.60 / $87.71	Professional		$41.74	$59.60	$87.71
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $18.68 / $27.59	Professional	26	$12.96	$18.68	$27.59
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $28.03 / $41.10 / $61.54	Professional	TC	$28.03	$41.10	$61.54
United Facility/Professional Professional Modifier Low / Median / High Price $31.76 / $40.01 / $82.46	Professional		$31.76	$40.01	$82.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $12.18 / $31.01	Professional	26	$9.74	$12.18	$31.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.98 / $29.17 / $58.76	Professional	TC	$21.98	$29.17	$58.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.06 / $33.06 / $33.06	Professional		$33.06	$33.06	$33.06
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $9.51 / $9.51	Professional	26	$9.51	$9.51	$9.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.56 / $23.56 / $23.56	Professional	TC	$23.56	$23.56	$23.56