Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.10 / $209.52 / $524.91	Professional		$92.10	$209.52	$524.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.65 / $38.95 / $104.25	Professional	26	$29.65	$38.95	$104.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.45 / $156.91 / $633.76	Professional	TC	$62.45	$156.91	$633.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.47 / $86.47 / $172.95	Professional		$86.47	$86.47	$172.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.39 / $31.26 / $99.44	Professional	26	$18.39	$31.26	$99.44
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $528.48 / $782.64 / $782.64	Facility		$528.48	$782.64	$782.64
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $213.67 / $213.67 / $213.67	Facility	26	$213.67	$213.67	$213.67
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $207.08 / $401.71 / $1,493.85	Professional		$207.08	$401.71	$1,493.85
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.82 / $91.08 / $304.95	Professional	26	$50.82	$91.08	$304.95
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $159.77 / $324.08 / $1,188.90	Professional	TC	$159.77	$324.08	$1,188.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.09 / $184.26 / $246.29	Professional		$56.09	$184.26	$246.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.63 / $40.47 / $56.59	Professional	26	$19.63	$40.47	$56.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.99 / $143.18 / $189.70	Professional	TC	$36.99	$143.18	$189.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $158.40 / $267.58 / $554.05	Facility		$158.40	$267.58	$554.05
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $37.51 / $74.98 / $113.43	Facility	26	$37.51	$74.98	$113.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $284.64 / $501.25	Professional		$165.00	$284.64	$501.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.38 / $75.88 / $103.75	Professional	26	$48.38	$75.88	$103.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $115.10 / $205.66 / $392.75	Professional	TC	$115.10	$205.66	$392.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.91 / $178.92 / $402.51	Professional		$33.91	$178.92	$402.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $253.04 / $340.00 / $347.73	Facility		$253.04	$340.00	$347.73
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $61.05 / $74.37 / $76.38	Facility	26	$61.05	$74.37	$76.38
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $46.85 / $61.05 / $90.06	Professional	26	$46.85	$61.05	$90.06
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $186.50 / $241.80 / $294.67	Professional	TC	$186.50	$241.80	$294.67
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $235.11 / $395.63 / $460.12	Professional		$235.11	$395.63	$460.12
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.83 / $86.34 / $101.94	Professional	26	$51.83	$86.34	$101.94
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $184.82 / $309.39 / $358.18	Professional	TC	$184.82	$309.39	$358.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $207.08 / $315.63 / $415.83	Professional		$207.08	$315.63	$415.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $50.82 / $69.93 / $90.95	Professional	26	$50.82	$69.93	$90.95
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $138.13 / $245.70 / $323.70	Professional	TC	$138.13	$245.70	$323.70
United Facility/Professional Professional Modifier Low / Median / High Price $104.41 / $149.09 / $273.04	Professional		$104.41	$149.09	$273.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.57 / $24.50 / $62.36	Professional	26	$22.57	$24.50	$62.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.29 / $81.20 / $210.68	Professional	TC	$79.29	$81.20	$210.68