Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.12 / $18.87 / $42.22	Facility	26	$18.12	$18.87	$42.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.29 / $34.36 / $151.88	Professional		$26.29	$34.36	$151.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.89 / $9.53 / $20.21	Professional	26	$6.89	$9.53	$20.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.41 / $25.42 / $55.84	Professional	TC	$19.41	$25.42	$55.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $60.47 / $89.42	Professional		$32.97	$60.47	$89.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $16.37 / $24.12	Professional	26	$9.31	$16.37	$24.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.66 / $42.55 / $67.51	Professional	TC	$24.66	$42.55	$67.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.78 / $75.91 / $87.86	Professional		$63.78	$75.91	$87.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $19.12 / $21.52	Professional	26	$15.96	$19.12	$21.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $47.33 / $56.51 / $66.33	Professional	TC	$47.33	$56.51	$66.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.72 / $55.44 / $98.61	Professional		$48.72	$55.44	$98.61
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.35 / $16.18 / $25.41	Professional	26	$13.35	$16.18	$25.41
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.43 / $49.84 / $73.20	Professional	TC	$38.43	$49.84	$73.20
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $12.25 / $16.25 / $16.75	Facility	26	$12.25	$16.25	$16.75
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.50 / $15.08 / $18.75	Professional	26	$10.50	$15.08	$18.75
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $26.05 / $37.39 / $48.53	Professional	TC	$26.05	$37.39	$48.53
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.97 / $69.36 / $92.15	Professional		$48.97	$69.36	$92.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.33 / $16.77 / $24.58	Professional	26	$11.33	$16.77	$24.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $31.56 / $47.02 / $67.51	Professional	TC	$31.56	$47.02	$67.51
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 $57.34 / $67.41 / $88.47	Professional		$57.34	$67.41	$88.47
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.96 / $17.69 / $23.69	Professional	26	$14.96	$17.69	$23.69
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $41.93 / $50.04 / $65.67	Professional	TC	$41.93	$50.04	$65.67
United Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $38.75 / $89.93	Professional		$29.82	$38.75	$89.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.96 / $9.99 / $25.79	Professional	26	$8.96	$9.99	$25.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.18 / $26.20 / $64.09	Professional	TC	$21.18	$26.20	$64.09