Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.96 / $33.51 / $67.86	Facility	26	$22.96	$33.51	$67.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.14 / $50.56 / $233.00	Professional		$37.14	$50.56	$233.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $15.66 / $34.47	Professional	26	$11.09	$15.66	$34.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.22 / $34.72 / $86.75	Professional	TC	$26.22	$34.72	$86.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $15.41	Facility	26	$15.41	$15.41	$15.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.73 / $86.45 / $132.83	Professional		$46.73	$86.45	$132.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.11 / $26.65 / $38.82	Professional	26	$15.11	$26.65	$38.82
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 $94.27 / $111.99 / $129.66	Professional		$94.27	$111.99	$129.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.66 / $30.72 / $34.58	Professional	26	$25.66	$30.72	$34.58
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 $69.44 / $80.95 / $145.52	Professional		$69.44	$80.95	$145.52
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.35 / $25.87 / $40.65	Professional	26	$21.35	$25.87	$40.65
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.12 / $67.31 / $105.72	Professional	TC	$54.12	$67.31	$105.72
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $19.38 / $25.76 / $26.80	Facility	26	$19.38	$25.76	$26.80
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $18.23 / $24.19 / $30.60	Professional	26	$18.23	$24.19	$30.60
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $38.11 / $52.93 / $67.67	Professional	TC	$38.11	$52.93	$67.67
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $15.41	Facility	26	$15.41	$15.41	$15.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.76 / $100.80 / $137.75	Professional		$70.76	$100.80	$137.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $18.12 / $27.39 / $39.34	Professional	26	$18.12	$27.39	$39.34
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $42.55 / $68.06 / $97.64	Professional	TC	$42.55	$68.06	$97.64
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 $80.00 / $98.64 / $132.25	Professional		$80.00	$98.64	$132.25
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $23.94 / $28.30 / $37.90	Professional	26	$23.94	$28.30	$37.90
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $55.97 / $71.23 / $95.77	Professional	TC	$55.97	$71.23	$95.77
United Facility/Professional Professional Modifier Low / Median / High Price $42.40 / $57.52 / $135.41	Professional		$42.40	$57.52	$135.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.55 / $15.99 / $41.29	Professional	26	$13.55	$15.99	$41.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.35 / $41.53 / $94.05	Professional	TC	$28.35	$41.53	$94.05