Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.87 / $39.78 / $59.92	Facility	26	$24.87	$39.78	$59.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $59.37 / $111.41	Professional		$37.79	$59.37	$111.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $24.92 / $56.82	Professional	26	$20.50	$24.92	$56.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.44 / $33.32 / $57.56	Professional	TC	$16.44	$33.32	$57.56
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $35.61 / $80.00 / $98.31	Facility	26	$35.61	$80.00	$98.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $63.88 / $113.00 / $418.13	Professional		$63.88	$113.00	$418.13
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.38 / $40.33 / $143.25	Professional	26	$24.38	$40.33	$143.25
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.46 / $72.20 / $274.88	Professional	TC	$38.46	$72.20	$274.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.64 / $80.73 / $168.67	Professional		$41.64	$80.73	$168.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.32 / $35.27 / $57.64	Professional	26	$20.32	$35.27	$57.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.45 / $50.75 / $111.03	Professional	TC	$18.45	$50.75	$111.03
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $18.72 / $27.58 / $53.56	Facility	26	$18.72	$27.58	$53.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $48.94 / $92.18	Professional		$31.62	$48.94	$92.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.00 / $26.98 / $48.87	Professional	26	$18.00	$26.98	$48.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $14.08 / $21.75 / $43.14	Professional	TC	$14.08	$21.75	$43.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.66 / $50.15 / $91.10	Professional		$9.66	$50.15	$91.10
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $28.59 / $34.47 / $41.54	Facility	26	$28.59	$34.47	$41.54
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $24.39 / $32.76 / $42.60	Professional	26	$24.39	$32.76	$42.60
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $26.68 / $60.55	Professional	TC	$19.73	$26.68	$60.55
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $23.76 / $24.01 / $24.01	Facility	26	$23.76	$24.01	$24.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.93 / $110.67 / $132.44	Professional		$72.93	$110.67	$132.44
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $39.64 / $47.17	Professional	26	$27.23	$39.64	$47.17
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.95 / $69.06 / $85.27	Professional	TC	$46.95	$69.06	$85.27
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $47.86 / $58.88	Facility	26	$47.86	$47.86	$58.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.60 / $88.16 / $123.67	Professional		$60.60	$88.16	$123.67
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $24.49 / $33.29 / $43.99	Professional	26	$24.49	$33.29	$43.99
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $39.04 / $56.96 / $77.53	Professional	TC	$39.04	$56.96	$77.53
United Facility/Professional Professional Modifier Low / Median / High Price $46.92 / $64.28 / $141.54	Professional		$46.92	$64.28	$141.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.26 / $34.01 / $52.18	Professional	26	$22.26	$34.01	$52.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.91 / $36.57 / $84.11	Professional	TC	$20.91	$36.57	$84.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.75 / $54.47 / $54.47	Professional		$39.75	$54.47	$54.47
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $18.28 / $18.28	Professional	26	$14.36	$18.28	$18.28
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.40 / $36.19 / $36.19	Professional	TC	$25.40	$36.19	$36.19