Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.64 / $22.03 / $42.08	Facility	26	$19.64	$22.03	$42.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.85 / $35.89 / $157.00	Professional		$25.85	$35.89	$157.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.94 / $26.79	Professional	26	$7.08	$9.94	$26.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $59.24 / $59.24 / $59.24	Professional	50	$59.24	$59.24	$59.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.53 / $23.65 / $59.10	Professional	TC	$15.53	$23.65	$59.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.65 / $57.50 / $91.23	Professional		$29.65	$57.50	$91.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $16.14 / $24.40	Professional	26	$9.31	$16.14	$24.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.62 / $42.55 / $68.45	Professional	TC	$21.62	$42.55	$68.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.09 / $77.45 / $89.65	Professional		$65.09	$77.45	$89.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.88 / $22.38	Professional	26	$16.60	$19.88	$22.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $47.99 / $57.30 / $67.27	Professional	TC	$47.99	$57.30	$67.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $44.02 / $55.04 / $99.63	Professional		$44.02	$55.04	$99.63
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $17.36 / $26.43	Professional	26	$13.88	$17.36	$26.43
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.00 / $47.20 / $73.20	Professional	TC	$33.00	$47.20	$73.20
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $11.63 / $16.07 / $16.75	Facility	26	$11.63	$16.07	$16.75
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.32 / $14.81 / $17.95	Professional	26	$10.32	$14.81	$17.95
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $25.38 / $34.84 / $42.68	Professional	TC	$25.38	$34.84	$42.68
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.22 / $67.91 / $92.15	Professional		$47.22	$67.91	$92.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.62 / $17.03 / $24.40	Professional	26	$11.62	$17.03	$24.40
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.66 / $46.34 / $68.45	Professional	TC	$28.66	$46.34	$68.45
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $209.36 / $209.36 / $209.36	Facility	26	$209.36	$209.36	$209.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $53.68 / $67.13 / $89.16	Professional		$53.68	$67.13	$89.16
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $17.38 / $24.36	Professional	26	$14.76	$17.38	$24.36
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $38.40 / $49.78 / $65.51	Professional	TC	$38.40	$49.78	$65.51
United Facility/Professional Professional Modifier Low / Median / High Price $27.67 / $39.14 / $89.93	Professional		$27.67	$39.14	$89.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $12.48 / $24.80	Professional	26	$8.60	$12.48	$24.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $24.63 / $65.13	Professional	TC	$19.05	$24.63	$65.13