Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.26 / $62.31 / $108.80	Facility	26	$32.26	$62.31	$108.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.34 / $112.86 / $217.88	Professional		$80.34	$112.86	$217.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.98 / $80.59 / $155.40	Professional	TC	$54.98	$80.59	$155.40
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $124.11 / $124.11	Facility	26	$100.00	$124.11	$124.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $124.28 / $224.50 / $770.40	Professional		$124.28	$224.50	$770.40
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.93 / $155.03 / $542.70	Professional	TC	$85.93	$155.03	$542.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.53 / $172.19 / $289.64	Professional		$97.53	$172.19	$289.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.95 / $121.53 / $208.16	Professional	TC	$66.95	$121.53	$208.16
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $29.45 / $63.67 / $290.81	Facility	26	$29.45	$63.67	$290.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.17 / $199.74 / $309.33	Professional		$95.17	$199.74	$309.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $66.95 / $135.97 / $226.23	Professional	TC	$66.95	$135.97	$226.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.52 / $102.70 / $228.88	Professional		$21.52	$102.70	$228.88
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $45.06 / $54.03 / $60.30	Facility	26	$45.06	$54.03	$60.30
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $77.06 / $113.23 / $149.79	Professional	TC	$77.06	$113.23	$149.79
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $37.47 / $37.47 / $37.60	Facility	26	$37.47	$37.47	$37.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.69 / $210.76 / $255.14	Professional		$138.69	$210.76	$255.14
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.06 / $146.27 / $177.07	Professional	TC	$94.06	$146.27	$177.07
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $385.75	Facility	26	$211.40	$211.40	$385.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $124.28 / $185.46 / $242.82	Professional		$124.28	$185.46	$242.82
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $89.28 / $128.71 / $175.16	Professional	TC	$89.28	$128.71	$175.16
United Facility/Professional Professional Modifier Low / Median / High Price $94.16 / $126.11 / $257.67	Professional		$94.16	$126.11	$257.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.48 / $85.32 / $176.70	Professional	TC	$67.48	$85.32	$176.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $100.27 / $100.27 / $100.27	Professional		$100.27	$100.27	$100.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.58 / $71.58 / $71.58	Professional	TC	$71.58	$71.58	$71.58