Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $447.11 / $507.05 / $797.56	Professional		$447.11	$507.05	$797.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $48.98 / $90.54	Professional	26	$37.99	$48.98	$90.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $409.12 / $458.07 / $976.14	Professional	TC	$409.12	$458.07	$976.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Professional	26	$31.27	$31.27	$31.27
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $114.94 / $213.45 / $213.45	Facility	26	$114.94	$213.45	$213.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $554.79 / $1,028.17 / $3,641.70	Professional		$554.79	$1,028.17	$3,641.70
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.22 / $114.87 / $384.75	Professional	26	$64.22	$114.87	$384.75
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $489.17 / $920.92 / $3,256.95	Professional	TC	$489.17	$920.92	$3,256.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $273.57 / $474.99 / $690.46	Professional		$273.57	$474.99	$690.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.68 / $51.26 / $68.45	Professional	26	$24.68	$51.26	$68.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $247.47 / $422.94 / $618.69	Professional	TC	$247.47	$422.94	$618.69
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $61.53 / $98.23 / $141.56	Facility	26	$61.53	$98.23	$141.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $593.47 / $999.85 / $1,416.68	Professional		$593.47	$999.85	$1,416.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.53 / $98.23 / $129.47	Professional	26	$61.53	$98.23	$129.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $521.66 / $904.47 / $1,289.24	Professional	TC	$521.66	$904.47	$1,289.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.34 / $425.22 / $1,008.72	Professional		$47.34	$425.22	$1,008.72
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $77.00 / $93.63 / $97.15	Facility	26	$77.00	$93.63	$97.15
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $62.35 / $79.45 / $107.51	Professional	26	$62.35	$79.45	$107.51
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $537.54 / $709.71 / $897.00	Professional	TC	$537.54	$709.71	$897.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $587.36 / $988.45 / $1,159.25	Professional		$587.36	$988.45	$1,159.25
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.37 / $109.10 / $128.58	Professional	26	$65.37	$109.10	$128.58
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $521.99 / $877.92 / $1,036.15	Professional	TC	$521.99	$877.92	$1,036.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $592.75 / $818.31 / $1,039.16	Professional		$592.75	$818.31	$1,039.16
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $64.22 / $88.20 / $114.93	Professional	26	$64.22	$88.20	$114.93
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $528.53 / $734.98 / $922.96	Professional	TC	$528.53	$734.98	$922.96
United Facility/Professional Professional Modifier Low / Median / High Price $257.86 / $335.13 / $904.32	Professional		$257.86	$335.13	$904.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.53 / $45.61 / $117.81	Professional	26	$30.53	$45.61	$117.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $226.10 / $303.98 / $621.91	Professional	TC	$226.10	$303.98	$621.91