Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.22 / $30.58 / $56.17	Professional		$23.22	$30.58	$56.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.96 / $22.36 / $107.10	Professional	26	$16.96	$22.36	$107.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.27 / $8.22 / $18.20	Professional	TC	$6.27	$8.22	$18.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.87 / $56.87 / $56.87	Professional	26	$56.87	$56.87	$56.87
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $95.38 / $95.38	Facility	26	$80.00	$95.38	$95.38
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $38.81 / $69.02 / $246.83	Professional		$38.81	$69.02	$246.83
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.11 / $52.09 / $174.00	Professional	26	$29.11	$52.09	$174.00
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.69 / $19.04 / $72.75	Professional	TC	$9.69	$19.04	$72.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.84 / $31.31 / $43.39	Professional		$14.84	$31.31	$43.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.03 / $23.11 / $32.36	Professional	26	$11.03	$23.11	$32.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.82 / $8.65 / $11.33	Professional	TC	$3.82	$8.65	$11.33
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $21.39 / $36.96 / $57.23	Facility	26	$21.39	$36.96	$57.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.92 / $58.94 / $84.03	Professional		$36.92	$58.94	$84.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.58 / $43.36 / $59.16	Professional	26	$27.58	$43.36	$59.16
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $15.58 / $22.41	Professional	TC	$9.33	$15.58	$22.41
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $34.64 / $41.78 / $43.55	Facility	26	$34.64	$41.78	$43.55
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $25.73 / $37.99 / $50.40	Professional	26	$25.73	$37.99	$50.40
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $8.55 / $12.66 / $16.80	Professional	TC	$8.55	$12.66	$16.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.32 / $65.94 / $79.90	Professional		$40.32	$65.94	$79.90
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $49.45 / $57.86	Professional	26	$29.23	$49.45	$57.86
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.33 / $17.03 / $22.04	Professional	TC	$11.33	$17.03	$22.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.81 / $54.81 / $69.45	Professional		$38.81	$54.81	$69.45
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $29.11 / $39.69 / $52.09	Professional	26	$29.11	$39.69	$52.09
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $9.69 / $14.64 / $18.50	Professional	TC	$9.69	$14.64	$18.50
United Facility/Professional Professional Modifier Low / Median / High Price $18.19 / $18.64 / $61.86	Professional		$18.19	$18.64	$61.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $14.33 / $35.96	Professional	26	$13.86	$14.33	$35.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.33 / $4.88 / $14.73	Professional	TC	$4.33	$4.88	$14.73