Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.05 / $18.11 / $37.54	Facility	26	$11.05	$18.11	$37.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.76 / $37.67 / $76.94	Professional		$25.76	$37.67	$76.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $11.05 / $24.23	Professional	26	$8.48	$11.05	$24.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.28 / $26.15 / $46.26	Professional	TC	$17.28	$26.15	$46.26
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $80.00 / $80.00	Facility	26	$70.00	$80.00	$80.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $42.50 / $74.41 / $273.98	Professional		$42.50	$74.41	$273.98
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.40 / $22.95 / $232.03	Professional	26	$13.40	$22.95	$232.03
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.11 / $51.20 / $196.28	Professional	TC	$29.11	$51.20	$196.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $55.54 / $102.06	Professional		$29.82	$55.54	$102.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.57 / $18.30 / $28.40	Professional	26	$10.57	$18.30	$28.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.57 / $36.78 / $73.20	Professional	TC	$19.57	$36.78	$73.20
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $22.18 / $236.39	Facility	26	$10.23	$22.18	$236.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.84 / $61.22 / $82.62	Professional		$27.84	$61.22	$82.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $21.79 / $27.30	Professional	26	$10.23	$21.79	$27.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.52 / $36.26 / $57.96	Professional	TC	$17.52	$36.26	$57.96
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 $15.39 / $18.46 / $20.77	Facility	26	$15.39	$18.46	$20.77
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $31.13 / $31.13 / $31.13	Professional		$31.13	$31.13	$31.13
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $12.46 / $17.11 / $21.86	Professional	26	$12.46	$17.11	$21.86
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $30.72 / $39.65	Professional	TC	$19.30	$30.72	$39.65
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $12.80 / $12.80 / $13.14	Facility	26	$12.80	$12.80	$13.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.52 / $72.42 / $89.04	Professional		$48.52	$72.42	$89.04
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.97 / $22.02 / $26.66	Professional	26	$14.97	$22.02	$26.66
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.54 / $51.07 / $62.80	Professional	TC	$33.54	$51.07	$62.80
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 $44.16 / $64.20 / $85.33	Professional		$44.16	$64.20	$85.33
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.92 / $19.38 / $28.51	Professional	26	$13.92	$19.38	$28.51
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $29.11 / $44.67 / $60.18	Professional	TC	$29.11	$44.67	$60.18
United Facility/Professional Professional Modifier Low / Median / High Price $23.07 / $34.58 / $87.63	Professional		$23.07	$34.58	$87.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.64 / $14.22 / $29.43	Professional	26	$7.64	$14.22	$29.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.39 / $23.43 / $61.26	Professional	TC	$15.39	$23.43	$61.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.50 / $36.50 / $36.50	Professional		$36.50	$36.50	$36.50
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $9.78 / $9.78	Professional	26	$9.78	$9.78	$9.78
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.72 / $26.72 / $26.72	Professional	TC	$26.72	$26.72	$26.72