Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.60 / $78.34 / $124.11	Facility	26	$58.60	$78.34	$124.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $287.74 / $372.15 / $688.07	Professional		$287.74	$372.15	$688.07
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $141.10 / $186.08 / $331.16	Professional	52	$141.10	$186.08	$331.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $247.80 / $323.49 / $618.57	Professional	TC	$247.80	$323.49	$618.57
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $60.78 / $201.33 / $201.33	Facility	26	$60.78	$201.33	$201.33
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $414.05 / $731.84 / $3,264.23	Professional		$414.05	$731.84	$3,264.23
Asuris Northwest Health Facility/Professional Professional Modifier TC Low / Median / High Price $349.98 / $640.66 / $2,893.80	Professional	TC	$349.98	$640.66	$2,893.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.04 / $587.10 / $1,154.20	Professional		$317.04	$587.10	$1,154.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $292.77 / $541.64 / $1,024.52	Professional	TC	$292.77	$541.64	$1,024.52
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $40.06 / $66.56 / $113.91	Facility	26	$40.06	$66.56	$113.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $297.07 / $481.76 / $845.52	Professional		$297.07	$481.76	$845.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $257.70 / $415.53 / $743.59	Professional	TC	$257.70	$415.53	$743.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.51 / $436.13 / $939.28	Professional		$48.51	$436.13	$939.28
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $64.19 / $87.75 / $89.11	Facility	26	$64.19	$87.75	$89.11
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $533.83 / $649.13	Professional	TC	$363.08	$533.83	$649.13
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $60.25 / $60.25 / $60.78	Facility	26	$60.25	$60.25	$60.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $525.40 / $817.88 / $1,020.49	Professional		$525.40	$817.88	$1,020.49
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $461.65 / $721.18 / $899.84	Professional	TC	$461.65	$721.18	$899.84
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $946.29 / $946.29 / $1,497.68	Facility	26	$946.29	$946.29	$1,497.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $498.04 / $707.17 / $959.95	Professional		$498.04	$707.17	$959.95
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $436.59 / $619.91 / $846.46	Professional	TC	$436.59	$619.91	$846.46
United Facility/Professional Professional Modifier Low / Median / High Price $373.05 / $543.41 / $1,006.39	Professional		$373.05	$543.41	$1,006.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $333.84 / $479.36 / $923.01	Professional	TC	$333.84	$479.36	$923.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $308.37 / $374.23 / $434.93	Professional		$308.37	$374.23	$434.93
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $271.64 / $330.71 / $387.84	Professional	TC	$271.64	$330.71	$387.84