Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.85 / $91.39 / $182.35	Facility	26	$55.85	$91.39	$182.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.82 / $408.68 / $772.41	Professional		$293.82	$408.68	$772.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.47 / $55.86 / $111.72	Professional	26	$43.47	$55.86	$111.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $250.34 / $352.82 / $660.89	Professional	TC	$250.34	$352.82	$660.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.24 / $231.24 / $231.24	Professional		$231.24	$231.24	$231.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.17 / $27.17 / $89.76	Professional	26	$27.17	$27.17	$89.76
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $66.59 / $103.77 / $949.44	Facility	26	$66.59	$103.77	$949.44
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $431.52 / $712.93 / $2,033.50	Professional		$431.52	$712.93	$2,033.50
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.91 / $115.46 / $313.45	Professional	26	$67.91	$115.46	$313.45
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $366.83 / $613.62 / $1,720.04	Professional	TC	$366.83	$613.62	$1,720.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.12 / $714.04 / $1,064.38	Professional		$441.12	$714.04	$1,064.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.73 / $103.66 / $162.79	Professional	26	$66.73	$103.66	$162.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $374.39 / $609.92 / $902.63	Professional	TC	$374.39	$609.92	$902.63
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $120.99 / $2,162.39	Facility	26	$48.98	$120.99	$2,162.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $360.53 / $770.64 / $993.54	Professional		$360.53	$770.64	$993.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $117.52 / $148.12	Professional	26	$48.98	$117.52	$148.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $312.79 / $659.64 / $880.31	Professional	TC	$312.79	$659.64	$880.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.21 / $334.88 / $686.69	Professional		$49.21	$334.88	$686.69
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $80.80 / $97.20 / $101.17	Facility	26	$80.80	$97.20	$101.17
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $59.90 / $96.64 / $104.19	Professional	26	$59.90	$96.64	$104.19
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $324.82 / $489.26 / $608.28	Professional	TC	$324.82	$489.26	$608.28
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $66.59 / $66.59 / $67.18	Facility	26	$66.59	$66.59	$67.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $475.69 / $704.34 / $866.32	Professional		$475.69	$704.34	$866.32
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.51 / $112.06 / $137.78	Professional	26	$75.51	$112.06	$137.78
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $400.17 / $592.74 / $726.38	Professional	TC	$400.17	$592.74	$726.38
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 $434.74 / $643.82 / $901.31	Professional		$434.74	$643.82	$901.31
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $81.72 / $101.72 / $137.94	Professional	26	$81.72	$101.72	$137.94
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $424.15 / $545.29 / $763.35	Professional	TC	$424.15	$545.29	$763.35
United Facility/Professional Professional Modifier Low / Median / High Price $292.64 / $361.50 / $844.25	Professional		$292.64	$361.50	$844.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $56.46 / $139.63	Professional	26	$45.71	$56.46	$139.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $246.94 / $303.51 / $740.07	Professional	TC	$246.94	$303.51	$740.07