Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.29 / $24.60 / $62.72	Facility	26	$17.29	$24.60	$62.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.60 / $53.31 / $208.79	Professional		$38.60	$53.31	$208.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.25 / $14.88 / $60.00	Professional	26	$10.25	$14.88	$60.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $36.75 / $89.59	Professional	TC	$27.55	$36.75	$89.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.58 / $82.38 / $131.10	Professional		$45.58	$82.38	$131.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $24.69 / $36.39	Professional	26	$13.96	$24.69	$36.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.11 / $61.57 / $97.51	Professional	TC	$32.11	$61.57	$97.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $92.28 / $109.68 / $127.01	Professional		$92.28	$109.68	$127.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.73 / $28.39 / $31.96	Professional	26	$23.73	$28.39	$31.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $67.81 / $80.97 / $95.05	Professional	TC	$67.81	$80.97	$95.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $68.88 / $79.26 / $143.34	Professional		$68.88	$79.26	$143.34
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.75 / $23.94 / $37.61	Professional	26	$19.75	$23.94	$37.61
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.12 / $72.23 / $105.72	Professional	TC	$54.12	$72.23	$105.72
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $24.46 / $25.46	Facility	26	$18.62	$24.46	$25.46
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $15.28 / $21.46 / $26.79	Professional	26	$15.28	$21.46	$26.79
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $34.17 / $48.19 / $70.22	Professional	TC	$34.17	$48.19	$70.22
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.44 / $99.33 / $134.90	Professional		$68.44	$99.33	$134.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $16.76 / $25.31 / $36.76	Professional	26	$16.76	$25.31	$36.76
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $42.55 / $68.06 / $98.59	Professional	TC	$42.55	$68.06	$98.59
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $385.75 / $385.75 / $385.75	Facility	26	$385.75	$385.75	$385.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $78.20 / $97.27 / $129.52	Professional		$78.20	$97.27	$129.52
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $22.14 / $26.89 / $35.06	Professional	26	$22.14	$26.89	$35.06
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $55.97 / $71.93 / $95.77	Professional	TC	$55.97	$71.93	$95.77
United Facility/Professional Professional Modifier Low / Median / High Price $41.68 / $55.67 / $133.35	Professional		$41.68	$55.67	$133.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.25 / $14.78 / $38.90	Professional	26	$13.25	$14.78	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.03 / $37.63 / $93.94	Professional	TC	$28.03	$37.63	$93.94