Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.59 / $21.91 / $47.37	Facility	26	$15.59	$21.91	$47.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.91 / $33.47 / $87.17	Professional		$20.91	$33.47	$87.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $10.90 / $24.62	Professional	26	$7.86	$10.90	$24.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.65 / $23.06 / $56.61	Professional	TC	$14.65	$23.06	$56.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.79 / $10.79 / $10.79	Facility	26	$10.79	$10.79	$10.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.65 / $58.45 / $88.32	Professional		$32.65	$58.45	$88.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.45 / $19.05 / $28.00	Professional	26	$10.45	$19.05	$28.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.67 / $40.17 / $62.80	Professional	TC	$22.67	$40.17	$62.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.13 / $75.06 / $86.79	Professional		$63.13	$75.06	$86.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.53 / $22.28 / $25.08	Professional	26	$18.53	$22.28	$25.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $44.04 / $52.58 / $61.71	Professional	TC	$44.04	$52.58	$61.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.41 / $55.51 / $96.37	Professional		$46.41	$55.51	$96.37
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.48 / $18.11 / $29.49	Professional	26	$15.48	$18.11	$29.49
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.76 / $41.61 / $69.12	Professional	TC	$35.76	$41.61	$69.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $14.54 / $18.51 / $20.10	Facility	26	$14.54	$18.51	$20.10
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $16.82 / $20.10	Professional	26	$12.00	$16.82	$20.10
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.60 / $44.03	Professional	TC	$22.91	$33.60	$44.03
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.79 / $10.79 / $10.79	Facility	26	$10.79	$10.79	$10.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.97 / $68.27 / $91.20	Professional		$48.97	$68.27	$91.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.05 / $19.98 / $28.03	Professional	26	$13.05	$19.98	$28.03
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.04 / $44.28 / $63.72	Professional	TC	$29.04	$44.28	$63.72
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 $55.51 / $66.72 / $88.25	Professional		$55.51	$66.72	$88.25
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.36 / $20.66 / $27.48	Professional	26	$17.36	$20.66	$27.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $37.82 / $46.58 / $61.87	Professional	TC	$37.82	$46.58	$61.87
United Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $38.35 / $90.82	Professional		$29.82	$38.35	$90.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.39 / $10.78 / $29.71	Professional	26	$10.39	$10.78	$29.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.38 / $24.91 / $60.88	Professional	TC	$19.38	$24.91	$60.88