Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.63 / $94.52 / $155.46	Facility	26	$48.63	$94.52	$155.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.85 / $269.01 / $650.16	Professional		$210.85	$269.01	$650.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $166.21 / $220.38 / $526.15	Professional	TC	$166.21	$220.38	$526.15
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $57.58 / $100.00 / $949.44	Facility	26	$57.58	$100.00	$949.44
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $290.60 / $490.74 / $1,396.18	Professional		$290.60	$490.74	$1,396.18
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $231.46 / $390.70 / $1,165.91	Professional	TC	$231.46	$390.70	$1,165.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.95 / $481.02 / $718.51	Professional		$301.95	$481.02	$718.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $244.91 / $391.51 / $579.32	Professional	TC	$244.91	$391.51	$579.32
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $41.85 / $106.33 / $2,377.71	Facility	26	$41.85	$106.33	$2,377.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $234.67 / $545.37 / $687.18	Professional		$234.67	$545.37	$687.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $192.82 / $435.61 / $559.67	Professional	TC	$192.82	$435.61	$559.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.31 / $232.19 / $468.46	Professional		$42.31	$232.19	$468.46
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $63.21 / $84.42 / $88.43	Facility	26	$63.21	$84.42	$88.43
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $214.00 / $303.26 / $367.62	Professional	TC	$214.00	$303.26	$367.62
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $57.58 / $57.58 / $57.98	Facility	26	$57.58	$57.58	$57.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.04 / $474.04 / $577.38	Professional		$320.04	$474.04	$577.38
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $254.80 / $379.26 / $460.51	Professional	TC	$254.80	$379.26	$460.51
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $949.44 / $949.44 / $4,053.27	Facility	26	$949.44	$949.44	$4,053.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $290.60 / $432.54 / $617.12	Professional		$290.60	$432.54	$617.12
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $272.39 / $347.10 / $499.40	Professional	TC	$272.39	$347.10	$499.40
United Facility/Professional Professional Modifier Low / Median / High Price $196.02 / $242.14 / $591.86	Professional		$196.02	$242.14	$591.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.76 / $192.66 / $503.19	Professional	TC	$156.76	$192.66	$503.19