Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.42 / $14.06 / $23.12	Facility	26	$10.42	$14.06	$23.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $40.47 / $147.00	Professional		$26.80	$40.47	$147.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $37.15 / $47.07 / $47.07	Professional	25	$37.15	$47.07	$47.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $9.77 / $32.82	Professional	26	$7.73	$9.77	$32.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.38 / $29.62 / $53.80	Professional	TC	$18.38	$29.62	$53.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.36 / $50.41 / $58.56	Professional		$25.36	$50.41	$58.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.64 / $13.41 / $15.50	Professional	26	$9.64	$13.41	$15.50
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $16.19 / $100.00 / $100.00	Facility	26	$16.19	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $35.24 / $58.79 / $400.00	Professional		$35.24	$58.79	$400.00
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.97 / $17.21 / $132.09	Professional	26	$9.97	$17.21	$132.09
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.41 / $44.61 / $170.03	Professional	TC	$25.41	$44.61	$170.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.41 / $52.98 / $88.82	Professional		$31.41	$52.98	$88.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $14.15 / $24.31	Professional	26	$8.52	$14.15	$24.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.37 / $38.29 / $64.68	Professional	TC	$23.37	$38.29	$64.68
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $7.68 / $12.63 / $22.41	Facility	26	$7.68	$12.63	$22.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.93 / $50.56 / $84.93	Professional		$31.93	$50.56	$84.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $12.00 / $19.70	Professional	26	$7.44	$12.00	$19.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.49 / $39.50 / $62.81	Professional	TC	$24.49	$39.50	$62.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.48 / $53.61 / $98.32	Professional		$9.48	$53.61	$98.32
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $12.25 / $15.78 / $16.18	Facility	26	$12.25	$15.78	$16.18
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $13.20 / $16.57	Professional	26	$9.65	$13.20	$16.57
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $28.91 / $38.69 / $51.59	Professional	TC	$28.91	$38.69	$51.59
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $10.87 / $10.87 / $10.97	Facility	26	$10.87	$10.87	$10.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $60.87 / $76.16	Professional		$38.54	$60.87	$76.16
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.37 / $18.18 / $21.86	Professional	26	$11.37	$18.18	$21.86
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.08 / $42.61 / $54.36	Professional	TC	$27.08	$42.61	$54.36
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $270.73 / $270.73 / $459.43	Facility	26	$270.73	$270.73	$459.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.50 / $52.79 / $72.61	Professional		$36.50	$52.79	$72.61
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $15.60 / $20.48	Professional	26	$11.09	$15.60	$20.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $25.41 / $37.14 / $52.10	Professional	TC	$25.41	$37.14	$52.10
United Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $52.82 / $90.93	Professional		$34.00	$52.82	$90.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $12.97 / $23.16	Professional	26	$8.60	$12.97	$23.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.29 / $39.49 / $65.88	Professional	TC	$25.29	$39.49	$65.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.63 / $31.15 / $31.15	Professional		$22.63	$31.15	$31.15
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.62 / $8.38 / $8.38	Professional	26	$6.62	$8.38	$8.38
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.01 / $22.77 / $22.77	Professional	TC	$16.01	$22.77	$22.77