Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.80 / $22.00 / $37.96	Professional		$12.80	$22.00	$37.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.47 / $14.27 / $34.07	Professional	26	$9.47	$14.27	$34.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.28 / $9.65 / $17.46	Professional	TC	$5.28	$9.65	$17.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $6.36 / $20.34	Professional	26	$5.89	$6.36	$20.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $50.86 / $92.34 / $100.00	Facility		$50.86	$92.34	$100.00
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Asuris Northwest Health Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	TC	$100.00	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $27.63 / $50.43 / $174.00	Professional		$27.63	$50.43	$174.00
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $28.98 / $97.05	Professional	26	$16.50	$28.98	$97.05
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.81 / $19.25 / $95.76	Professional	TC	$9.81	$19.25	$95.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $22.05 / $30.71	Professional		$10.23	$22.05	$30.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.41 / $12.98 / $18.18	Professional	26	$6.41	$12.98	$18.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $4.11 / $9.41 / $12.70	Professional	TC	$4.11	$9.41	$12.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $21.39 / $33.56 / $55.47	Facility		$21.39	$33.56	$55.47
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $12.09 / $20.16 / $32.57	Facility	26	$12.09	$20.16	$32.57
Kaiser Permanente Facility/Professional Facility Modifier TC Low / Median / High Price $8.44 / $13.85 / $23.64	Facility	TC	$8.44	$13.85	$23.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.87 / $41.44 / $59.16	Professional		$25.87	$41.44	$59.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.70 / $24.39 / $33.44	Professional	26	$15.70	$24.39	$33.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $9.30 / $17.10 / $25.72	Professional	TC	$9.30	$17.10	$25.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.55 / $7.38 / $13.15	Professional		$5.55	$7.38	$13.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $29.52 / $40.06 / $42.21	Facility		$29.52	$40.06	$42.21
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $18.13 / $23.45 / $24.79	Facility	26	$18.13	$23.45	$24.79
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $11.14 / $16.29 / $17.42	Facility	TC	$11.14	$16.29	$17.42
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $18.97 / $28.51	Professional	26	$14.36	$18.97	$28.51
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $9.65 / $11.39 / $19.69	Professional	TC	$9.65	$11.39	$19.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.27 / $47.88 / $56.02	Professional		$28.27	$47.88	$56.02
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $27.56 / $32.81	Professional	26	$16.50	$27.56	$32.81
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.78 / $19.62 / $22.96	Professional	TC	$11.78	$19.62	$22.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.43 / $50.43	Professional		$28.18	$38.43	$50.43
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.63 / $22.68 / $29.76	Professional	26	$16.63	$22.68	$29.76
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $11.55 / $15.75 / $20.67	Professional	TC	$11.55	$15.75	$20.67
United Facility/Professional Professional Modifier Low / Median / High Price $12.40 / $13.21 / $34.26	Professional		$12.40	$13.21	$34.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.80 / $11.04 / $26.01	Professional	26	$7.80	$11.04	$26.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $5.08 / $8.47 / $20.88	Professional	TC	$5.08	$8.47	$20.88