Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $23.44 / $26.30	Facility	26	$16.98	$23.44	$26.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $42.66 / $114.82	Professional		$30.20	$42.66	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.88 / $34.67	Professional	26	$8.91	$12.88	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $60.26	Professional	TC	$20.89	$30.20	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $74.13 / $112.20	Professional		$39.81	$74.13	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $20.89 / $34.67	Professional	26	$12.59	$20.89	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $52.48 / $81.28	Professional	TC	$28.84	$52.48	$81.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $81.28 / $102.33	Professional		$72.44	$81.28	$102.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $22.39 / $26.92	Professional	26	$19.50	$22.39	$26.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $58.88 / $75.86	Professional	TC	$52.48	$58.88	$75.86
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $26.30 / $26.30	Facility	26	$17.78	$26.30	$26.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $72.44 / $112.20	Professional		$43.65	$72.44	$112.20
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $21.38 / $30.90	Professional	26	$11.22	$21.38	$30.90
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $52.48 / $75.86	Professional	TC	$28.18	$52.48	$75.86
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $20.42 / $23.99	Facility	26	$16.98	$20.42	$23.99
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $20.42 / $25.12	Professional	26	$14.45	$20.42	$25.12
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $42.66 / $53.70	Professional	TC	$31.62	$42.66	$53.70
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.51 / $11.75 / $16.98	Facility	26	$2.51	$11.75	$16.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $109.65	Professional		$60.26	$79.43	$109.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $23.99 / $31.62	Professional	26	$15.14	$23.99	$31.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $53.70 / $79.43	Professional	TC	$36.31	$53.70	$79.43
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 $66.07 / $77.62 / $100.00	Professional		$66.07	$77.62	$100.00
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $22.91 / $29.51	Professional	26	$18.62	$22.91	$29.51
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $56.23 / $72.44	Professional	TC	$46.77	$56.23	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $44.67 / $97.72	Professional		$37.15	$44.67	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $14.13 / $30.20	Professional	26	$11.48	$14.13	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $30.90 / $70.79	Professional	TC	$24.55	$30.90	$70.79