Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $58.55 / $107.19	Professional		$34.54	$58.55	$107.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.61 / $34.67 / $3,650.85	Professional	26	$23.61	$34.67	$3,650.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.92 / $26.89 / $37.99	Professional	TC	$10.92	$26.89	$37.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.88 / $26.88 / $26.88	Professional	26	$26.88	$26.88	$26.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $134.18 / $248.27 / $248.27	Facility		$134.18	$248.27	$248.27
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $134.74 / $134.74	Facility	26	$100.00	$134.74	$134.74
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $68.61 / $130.63 / $462.08	Professional		$68.61	$130.63	$462.08
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.65 / $68.52 / $250.96	Professional	26	$40.65	$68.52	$250.96
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.66 / $56.97 / $250.96	Professional	TC	$21.66	$56.97	$250.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.86 / $56.17 / $76.59	Professional		$21.86	$56.17	$76.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.78 / $32.52 / $45.53	Professional	26	$15.78	$32.52	$45.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $6.69 / $25.89 / $33.36	Professional	TC	$6.69	$25.89	$33.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $51.46 / $80.98 / $141.47	Facility		$51.46	$80.98	$141.47
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $49.05 / $80.12	Facility	26	$30.07	$49.05	$80.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.02 / $99.98 / $148.85	Professional		$57.02	$99.98	$148.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.61 / $60.29 / $83.17	Professional	26	$38.61	$60.29	$83.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.72 / $34.76 / $67.45	Professional	TC	$18.72	$34.76	$67.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.79 / $63.88 / $148.14	Professional		$10.79	$63.88	$148.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $71.98 / $103.18 / $109.21	Facility		$71.98	$103.18	$109.21
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $44.10 / $58.96 / $60.52	Facility	26	$44.10	$58.96	$60.52
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $36.58 / $55.38 / $71.89	Professional	26	$36.58	$55.38	$71.89
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $20.38 / $31.23 / $55.20	Professional	TC	$20.38	$31.23	$55.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.53 / $124.01 / $149.69	Professional		$75.53	$124.01	$149.69
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.09 / $69.29 / $81.73	Professional	26	$41.09	$69.29	$81.73
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.97 / $56.20 / $67.95	Professional	TC	$33.97	$56.20	$67.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $72.39 / $101.94 / $130.63	Professional		$72.39	$101.94	$130.63
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $40.65 / $56.07 / $73.59	Professional	26	$40.65	$56.07	$73.59
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $24.42 / $46.28 / $58.05	Professional	TC	$24.42	$46.28	$58.05
United Facility/Professional Professional Modifier Low / Median / High Price $33.14 / $53.05 / $128.66	Professional		$33.14	$53.05	$128.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.32 / $19.48 / $50.56	Professional	26	$19.32	$19.48	$50.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.86 / $15.04 / $47.12	Professional	TC	$13.86	$15.04	$47.12