Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.17 / $21.96 / $49.05	Facility	26	$17.17	$21.96	$49.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.87 / $21.22 / $40.36	Professional		$13.87	$21.22	$40.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $10.70 / $24.92	Professional	26	$7.90	$10.70	$24.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.97 / $11.42 / $18.44	Professional	TC	$5.97	$11.42	$18.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.16	Facility	26	$11.16	$11.16	$11.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.59 / $38.74 / $54.55	Professional		$23.59	$38.74	$54.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $20.64 / $29.73	Professional	26	$11.22	$20.64	$29.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.90 / $18.47 / $25.94	Professional	TC	$10.90	$18.47	$25.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.36 / $44.21 / $50.60	Professional		$37.36	$44.21	$50.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.19 / $23.03 / $25.94	Professional	26	$19.19	$23.03	$25.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.61 / $21.02 / $24.66	Professional	TC	$17.61	$21.02	$24.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.43 / $37.79 / $54.90	Professional		$30.43	$37.79	$54.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.01 / $19.62 / $31.35	Professional	26	$16.01	$19.62	$31.35
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.40 / $19.94 / $29.04	Professional	TC	$14.40	$19.94	$29.04
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $15.50 / $19.43 / $21.24	Facility	26	$15.50	$19.43	$21.24
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $13.68 / $18.39 / $21.92	Professional	26	$13.68	$18.39	$21.92
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $11.34 / $16.07 / $20.46	Professional	TC	$11.34	$16.07	$20.46
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.16	Facility	26	$11.16	$11.16	$11.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.27 / $41.30 / $52.87	Professional		$31.27	$41.30	$52.87
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.14 / $20.81 / $29.73	Professional	26	$13.14	$20.81	$29.73
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $10.87 / $18.55 / $25.57	Professional	TC	$10.87	$18.55	$25.57
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 $32.32 / $39.61 / $51.17	Professional		$32.32	$39.61	$51.17
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.36 / $21.93 / $27.48	Professional	26	$17.36	$21.93	$27.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $14.96 / $19.05 / $23.69	Professional	TC	$14.96	$19.05	$23.69
United Facility/Professional Professional Modifier Low / Median / High Price $19.48 / $26.06 / $55.73	Professional		$19.48	$26.06	$55.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $12.22 / $30.73	Professional	26	$10.80	$12.22	$30.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.66 / $11.26 / $24.80	Professional	TC	$8.66	$11.26	$24.80