Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.21 / $46.66 / $75.92	Professional		$27.21	$46.66	$75.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.71 / $18.02 / $25.18	Professional	26	$12.71	$18.02	$25.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.77 / $25.82 / $51.13	Professional	TC	$13.77	$25.82	$51.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $43.94 / $98.62 / $171.87	Facility		$43.94	$98.62	$171.87
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $20.84 / $36.40 / $100.00	Facility	26	$20.84	$36.40	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $44.81 / $82.52 / $354.38	Professional		$44.81	$82.52	$354.38
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $39.17 / $130.50	Professional	26	$19.60	$39.17	$130.50
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.56 / $41.15 / $180.44	Professional	TC	$23.56	$41.15	$180.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.71 / $59.61 / $103.18	Professional		$33.71	$59.61	$103.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.90 / $25.95 / $47.38	Professional	26	$15.90	$25.95	$47.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $31.61 / $62.41	Professional	TC	$17.39	$31.61	$62.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.15 / $53.95 / $106.87	Facility		$34.15	$53.95	$106.87
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $15.68 / $24.18 / $43.21	Facility	26	$15.68	$24.18	$43.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $52.98 / $96.84	Professional		$33.47	$52.98	$96.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.64 / $24.18 / $41.38	Professional	26	$15.64	$24.18	$41.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.85 / $29.32 / $52.00	Professional	TC	$17.85	$29.32	$52.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.93 / $51.08 / $93.58	Professional		$8.93	$51.08	$93.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $48.70 / $64.31 / $79.80	Facility		$48.70	$64.31	$79.80
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $24.01 / $31.10 / $32.15	Facility	26	$24.01	$31.10	$32.15
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $19.43 / $27.36 / $34.29	Professional	26	$19.43	$27.36	$34.29
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $32.00 / $54.52	Professional	TC	$21.00	$32.00	$54.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.94 / $43.94 / $43.94	Facility		$43.94	$43.94	$43.94
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $20.84 / $20.84 / $20.84	Facility	26	$20.84	$20.84	$20.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.43 / $78.16 / $90.71	Professional		$51.43	$78.16	$90.71
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.42 / $37.01 / $42.80	Professional	26	$24.42	$37.01	$42.80
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.01 / $41.05 / $48.08	Professional	TC	$27.01	$41.05	$48.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $44.81 / $65.05 / $82.48	Professional		$44.81	$65.05	$82.48
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $21.25 / $30.57 / $39.01	Professional	26	$21.25	$30.57	$39.01
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $23.56 / $34.47 / $43.71	Professional	TC	$23.56	$34.47	$43.71
United Facility/Professional Professional Modifier Low / Median / High Price $24.26 / $54.04 / $94.06	Professional		$24.26	$54.04	$94.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $24.38 / $45.28	Professional	26	$11.40	$24.38	$45.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.86 / $27.94 / $49.39	Professional	TC	$12.86	$27.94	$49.39