Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $19.05 / $21.38	Facility	26	$10.96	$19.05	$21.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $34.67 / $93.33	Professional		$25.12	$34.67	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $23.44	Professional	26	$6.03	$8.91	$23.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $53.70	Professional	TC	$18.20	$25.70	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $61.66 / $95.50	Professional		$31.62	$61.66	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.85 / $24.55	Professional	26	$8.91	$15.85	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $45.71 / $70.79	Professional	TC	$23.99	$45.71	$70.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $87.10	Professional		$63.10	$69.18	$87.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $17.78 / $21.38	Professional	26	$15.85	$17.78	$21.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $51.29 / $66.07	Professional	TC	$46.77	$51.29	$66.07
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $19.50 / $19.50	Facility	26	$19.50	$19.50	$19.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $58.88 / $95.50	Professional		$38.90	$58.88	$95.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $16.98 / $24.55	Professional	26	$8.91	$16.98	$24.55
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $46.77 / $70.79	Professional	TC	$26.30	$46.77	$70.79
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $16.60 / $16.60	Facility	26	$13.80	$16.60	$16.60
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.79 / $17.78	Professional	26	$10.00	$14.79	$17.78
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $36.31 / $47.86	Professional	TC	$26.30	$36.31	$47.86
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $66.07 / $93.33	Professional		$50.12	$66.07	$93.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $17.38 / $24.55	Professional	26	$11.75	$17.38	$24.55
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $45.71 / $70.79	Professional	TC	$30.90	$45.71	$70.79
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	26	$208.93	$208.93	$208.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $85.11	Professional		$56.23	$66.07	$85.11
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $17.78 / $22.91	Professional	26	$15.14	$17.78	$22.91
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $48.98 / $63.10	Professional	TC	$39.81	$48.98	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.90 / $85.11	Professional		$29.51	$38.90	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.00 / $23.44	Professional	26	$8.13	$10.00	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $26.92 / $63.10	Professional	TC	$20.89	$26.92	$63.10