Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.07 / $18.61 / $33.52	Facility	26	$17.07	$18.61	$33.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.26 / $43.22 / $86.27	Professional		$18.26	$43.22	$86.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $15.66 / $37.08	Professional	26	$7.48	$15.66	$37.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.11 / $23.33 / $49.94	Professional	TC	$10.11	$23.33	$49.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.11 / $80.11 / $80.11	Professional		$80.11	$80.11	$80.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.43 / $24.00 / $25.99	Professional	26	$8.43	$24.00	$25.99
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 $41.10 / $96.86 / $738.38	Professional		$41.10	$96.86	$738.38
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $35.47 / $125.63	Professional	26	$16.48	$35.47	$125.63
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $59.35 / $724.28	Professional	TC	$21.94	$59.35	$724.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.47 / $57.67 / $132.21	Professional		$21.47	$57.67	$132.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.05 / $19.78 / $45.04	Professional	26	$9.05	$19.78	$45.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.56 / $34.61 / $86.62	Professional	TC	$11.56	$34.61	$86.62
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $9.38 / $18.38 / $1,368.97	Facility	26	$9.38	$18.38	$1,368.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $17.52 / $36.72 / $109.76	Professional		$17.52	$36.72	$109.76
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $17.43 / $36.38	Professional	26	$8.61	$17.43	$36.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $10.23 / $19.76 / $71.17	Professional	TC	$10.23	$19.76	$71.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.16 / $54.50 / $92.81	Professional		$9.16	$54.50	$92.81
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $13.11 / $27.14 / $30.15	Facility	26	$13.11	$27.14	$30.15
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $16.16 / $16.16 / $16.16	Professional		$16.16	$16.16	$16.16
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $15.41 / $30.15	Professional	26	$10.80	$15.41	$30.15
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $13.81 / $19.73 / $52.48	Professional	TC	$13.81	$19.73	$52.48
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $20.39 / $20.39 / $20.57	Facility	26	$20.39	$20.39	$20.57
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.49 / $97.57 / $119.97	Professional		$61.49	$97.57	$119.97
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.96 / $34.83 / $42.18	Professional	26	$21.96	$34.83	$42.18
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.11 / $63.27 / $77.80	Professional	TC	$39.11	$63.27	$77.80
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $936.81 / $936.81 / $1,640.24	Facility	26	$936.81	$936.81	$1,640.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $84.15 / $114.97	Professional		$50.00	$84.15	$114.97
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $20.79 / $30.83 / $42.03	Professional	26	$20.79	$30.83	$42.03
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $35.11 / $54.20 / $74.55	Professional	TC	$35.11	$54.20	$74.55
United Facility/Professional Professional Modifier Low / Median / High Price $19.84 / $46.97 / $119.19	Professional		$19.84	$46.97	$119.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $16.78 / $42.76	Professional	26	$8.30	$16.78	$42.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.54 / $27.45 / $73.84	Professional	TC	$11.54	$27.45	$73.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.78 / $48.78 / $48.78	Professional		$48.78	$48.78	$48.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.75 / $15.75 / $15.75	Professional	26	$15.75	$15.75	$15.75
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $33.03 / $33.03	Professional	TC	$33.03	$33.03	$33.03