Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.49 / $58.81 / $136.41	Professional		$43.49	$58.81	$136.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.61 / $52.10 / $120.39	Professional	26	$27.61	$52.10	$120.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.87 / $22.19 / $51.19	Professional	TC	$15.87	$22.19	$51.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.29 / $57.53 / $93.13	Professional	26	$18.29	$57.53	$93.13
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $155.94 / $155.94	Facility	26	$100.00	$155.94	$155.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $66.63 / $124.15 / $473.28	Professional		$66.63	$124.15	$473.28
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.12 / $79.30 / $346.00	Professional	26	$47.12	$79.30	$346.00
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.05 / $47.13 / $330.22	Professional	TC	$24.05	$47.13	$330.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.52 / $58.97 / $82.47	Professional		$27.52	$58.97	$82.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.73 / $37.90 / $53.07	Professional	26	$17.73	$37.90	$53.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.08 / $22.42 / $28.90	Professional	TC	$10.08	$22.42	$28.90
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $35.03 / $69.72 / $105.00	Facility	26	$35.03	$69.72	$105.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.02 / $109.75 / $160.35	Professional		$70.02	$109.75	$160.35
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.76 / $70.45 / $96.04	Professional	26	$42.76	$70.45	$96.04
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.03 / $39.29 / $59.18	Professional	TC	$25.03	$39.29	$59.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.83 / $63.87 / $148.01	Professional		$10.83	$63.87	$148.01
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $51.36 / $68.34 / $71.02	Facility	26	$51.36	$68.34	$71.02
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $41.36 / $63.92 / $79.50	Professional	26	$41.36	$63.92	$79.50
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $21.71 / $33.77 / $43.50	Professional	TC	$21.71	$33.77	$43.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $125.58 / $151.54	Professional		$76.45	$125.58	$151.54
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.62 / $80.31 / $94.60	Professional	26	$47.62	$80.31	$94.60
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.45 / $45.89 / $56.94	Professional	TC	$29.45	$45.89	$56.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $73.45 / $103.19 / $132.29	Professional		$73.45	$103.19	$132.29
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.12 / $64.89 / $85.16	Professional	26	$47.12	$64.89	$85.16
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $26.33 / $38.39 / $50.21	Professional	TC	$26.33	$38.39	$50.21
United Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $48.47 / $88.76	Professional		$33.54	$48.47	$88.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.94 / $22.77 / $74.39	Professional	26	$20.94	$22.77	$74.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.69 / $12.61 / $30.34	Professional	TC	$11.69	$12.61	$30.34