Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.19 / $33.15 / $53.31	Professional		$23.19	$33.15	$53.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.04 / $23.01 / $32.78	Professional	26	$19.04	$23.01	$32.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.90 / $5.93 / $28.32	Professional	TC	$3.90	$5.93	$28.32
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.63 / $48.22 / $100.00	Facility	26	$27.63	$48.22	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $25.88 / $59.37 / $313.77	Professional		$25.88	$59.37	$313.77
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.05 / $43.90 / $171.60	Professional	26	$21.05	$43.90	$171.60
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.49 / $10.29 / $220.13	Professional	TC	$4.49	$10.29	$220.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.42 / $43.15 / $78.45	Professional		$24.42	$43.15	$78.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $32.54 / $62.56	Professional	26	$20.05	$32.54	$62.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.49 / $7.92 / $29.57	Professional	TC	$3.49	$7.92	$29.57
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $19.84 / $29.12 / $53.16	Facility	26	$19.84	$29.12	$53.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $44.13 / $80.08	Professional		$25.77	$44.13	$80.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.20 / $29.97 / $52.83	Professional	26	$19.20	$29.97	$52.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $4.00 / $9.27 / $49.50	Professional	TC	$4.00	$9.27	$49.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.87 / $13.13 / $16.03	Professional		$2.87	$13.13	$16.03
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $29.40 / $40.20 / $41.54	Facility	26	$29.40	$40.20	$41.54
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $23.87 / $31.80 / $41.88	Professional	26	$23.87	$31.80	$41.88
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $4.83 / $8.93 / $37.84	Professional	TC	$4.83	$8.93	$37.84
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $27.63 / $27.63 / $27.63	Facility	26	$27.63	$27.63	$27.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.96 / $59.06 / $68.30	Professional		$38.96	$59.06	$68.30
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.21 / $48.82 / $56.46	Professional	26	$32.21	$48.82	$56.46
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $6.75 / $10.22 / $11.84	Professional	TC	$6.75	$10.22	$11.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $24.59 / $25.88 / $49.99	Professional		$24.59	$25.88	$49.99
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $20.32 / $21.39 / $41.32	Professional	26	$20.32	$21.39	$41.32
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $4.26 / $4.83 / $8.66	Professional	TC	$4.26	$4.83	$8.66
United Facility/Professional Professional Modifier Low / Median / High Price $24.26 / $41.03 / $72.43	Professional		$24.26	$41.03	$72.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $31.19 / $59.12	Professional	26	$20.05	$31.19	$59.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.21 / $7.25 / $16.21	Professional	TC	$4.21	$7.25	$16.21