Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.59 / $38.47 / $67.58	Professional		$26.59	$38.47	$67.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.73 / $25.58 / $39.15	Professional	26	$17.73	$25.58	$39.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.30 / $18.97 / $26.82	Professional	52	$13.30	$18.97	$26.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.83 / $6.17 / $37.40	Professional	TC	$3.83	$6.17	$37.40
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $33.07 / $57.67 / $112.04	Facility	26	$33.07	$57.67	$112.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $29.67 / $57.32 / $303.81	Professional		$29.67	$57.32	$303.81
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.19 / $53.18 / $201.60	Professional	26	$25.19	$53.18	$201.60
Asuris Northwest Health Facility/Professional Professional Modifier 52 Low / Median / High Price $16.84 / $16.84 / $16.84	Professional	52	$16.84	$16.84	$16.84
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.49 / $10.29 / $211.93	Professional	TC	$4.49	$10.29	$211.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.87 / $48.14 / $87.93	Professional		$27.87	$48.14	$87.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.73 / $37.76 / $73.67	Professional	26	$20.73	$37.76	$73.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.27 / $7.92 / $33.86	Professional	TC	$3.27	$7.92	$33.86
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $17.55 / $30.13 / $63.45	Facility	26	$17.55	$30.13	$63.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.60 / $45.60 / $84.40	Professional		$26.60	$45.60	$84.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.63 / $31.85 / $59.44	Professional	26	$17.63	$31.85	$59.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $3.60 / $8.99 / $57.00	Professional	TC	$3.60	$8.99	$57.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.67 / $15.38 / $18.50	Professional		$2.67	$15.38	$18.50
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $30.13 / $47.57 / $48.91	Facility	26	$30.13	$47.57	$48.91
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $23.74 / $32.83 / $50.12	Professional	26	$23.74	$32.83	$50.12
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $4.49 / $8.93 / $47.31	Professional	TC	$4.49	$8.93	$47.31
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $33.07 / $33.07 / $33.07	Facility	26	$33.07	$33.07	$33.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.68 / $67.72 / $78.31	Professional		$44.68	$67.72	$78.31
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.92 / $57.48 / $66.48	Professional	26	$37.92	$57.48	$66.48
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 $28.19 / $29.67 / $57.32	Professional		$28.19	$29.67	$57.32
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $25.19 / $48.65	Professional	26	$23.93	$25.19	$48.65
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $4.26 / $4.49 / $8.66	Professional	TC	$4.26	$4.49	$8.66
United Facility/Professional Professional Modifier Low / Median / High Price $27.82 / $46.67 / $83.17	Professional		$27.82	$46.67	$83.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.00 / $36.72 / $71.27	Professional	26	$23.00	$36.72	$71.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.88 / $7.10 / $16.18	Professional	TC	$3.88	$7.10	$16.18