Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $11.66 / $27.61	Professional	26	$7.22	$11.66	$27.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.95 / $28.57 / $74.43	Professional	TC	$17.95	$28.57	$74.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.26 / $21.07 / $30.04	Professional	26	$11.26	$21.07	$30.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.15 / $48.59 / $76.03	Professional	TC	$27.15	$48.59	$76.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.48 / $24.58 / $27.70	Professional	26	$20.48	$24.58	$27.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.61 / $62.82 / $73.76	Professional	TC	$52.61	$62.82	$73.76
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $20.70 / $32.52	Professional	26	$17.07	$20.70	$32.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.70 / $54.61 / $82.35	Professional	TC	$42.70	$54.61	$82.35
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $13.76 / $17.98 / $24.00	Professional	26	$13.76	$17.98	$24.00
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $31.01 / $42.24 / $54.27	Professional	TC	$31.01	$42.24	$54.27
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.43 / $21.32 / $31.10	Professional	26	$14.43	$21.32	$31.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $35.90 / $55.21 / $76.15	Professional	TC	$35.90	$55.21	$76.15
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $19.07 / $22.24 / $30.32	Professional	26	$19.07	$22.24	$30.32
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $46.97 / $56.30 / $75.90	Professional	TC	$46.97	$56.30	$75.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.11 / $12.48 / $33.03	Professional	26	$11.11	$12.48	$33.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.71 / $28.77 / $78.56	Professional	TC	$23.71	$28.77	$78.56