Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.46 / $71.45 / $153.40	Facility	26	$47.46	$71.45	$153.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $408.92 / $544.34 / $1,214.27	Professional		$408.92	$544.34	$1,214.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.71 / $47.46 / $104.91	Professional	26	$36.71	$47.46	$104.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $367.72 / $496.88 / $993.76	Professional	TC	$367.72	$496.88	$993.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $731.53 / $731.53 / $731.53	Professional		$731.53	$731.53	$731.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.13 / $67.29 / $112.27	Professional	26	$33.13	$67.29	$112.27
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $56.63 / $87.58 / $949.44	Facility	26	$56.63	$87.58	$949.44
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $561.66 / $938.51 / $2,679.53	Professional		$561.66	$938.51	$2,679.53
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.75 / $98.18 / $266.22	Professional	26	$57.75	$98.18	$266.22
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $514.66 / $861.74 / $2,413.31	Professional	TC	$514.66	$861.74	$2,413.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $592.87 / $943.24 / $1,402.38	Professional		$592.87	$943.24	$1,402.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.51 / $87.90 / $138.36	Professional	26	$56.51	$87.90	$138.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $536.36 / $855.35 / $1,265.82	Professional	TC	$536.36	$855.35	$1,265.82
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $41.54 / $102.06 / $2,162.39	Facility	26	$41.54	$102.06	$2,162.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $485.46 / $1,020.03 / $1,340.56	Professional		$485.46	$1,020.03	$1,340.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.54 / $99.13 / $125.62	Professional	26	$41.54	$99.13	$125.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $445.47 / $962.11 / $1,235.61	Professional	TC	$445.47	$962.11	$1,235.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.83 / $467.82 / $938.56	Professional		$49.83	$467.82	$938.56
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $68.20 / $82.50 / $85.09	Facility	26	$68.20	$82.50	$85.09
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $52.07 / $74.09 / $85.09	Professional	26	$52.07	$74.09	$85.09
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $486.26 / $668.22 / $794.62	Professional	TC	$486.26	$668.22	$794.62
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $56.63 / $56.63 / $56.67	Facility	26	$56.63	$56.63	$56.67
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $626.20 / $924.16 / $1,136.69	Professional		$626.20	$924.16	$1,136.69
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.20 / $95.11 / $116.23	Professional	26	$64.20	$95.11	$116.23
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $561.99 / $832.42 / $1,018.64	Professional	TC	$561.99	$832.42	$1,018.64
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $949.44 / $949.44 / $1,526.97	Facility	26	$949.44	$949.44	$1,526.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $572.41 / $844.76 / $1,210.33	Professional		$572.41	$844.76	$1,210.33
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $68.93 / $85.89 / $116.80	Professional	26	$68.93	$85.89	$116.80
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $594.80 / $765.80 / $1,093.52	Professional	TC	$594.80	$765.80	$1,093.52
United Facility/Professional Professional Modifier Low / Median / High Price $388.67 / $480.12 / $1,158.04	Professional		$388.67	$480.12	$1,158.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.65 / $47.88 / $113.97	Professional	26	$38.65	$47.88	$113.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $349.71 / $432.00 / $1,094.58	Professional	TC	$349.71	$432.00	$1,094.58