Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.09 / $19.61 / $40.61	Facility	26	$12.09	$19.61	$40.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $35.09 / $138.77	Professional		$24.92	$35.09	$138.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $12.05 / $42.45	Professional	26	$7.33	$12.05	$42.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $24.30 / $56.16	Professional	TC	$17.57	$24.30	$56.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.04 / $55.69 / $86.51	Professional		$30.04	$55.69	$86.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $16.30 / $24.40	Professional	26	$9.31	$16.30	$24.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.05 / $40.76 / $63.74	Professional	TC	$21.05	$40.76	$63.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.81 / $73.51 / $85.03	Professional		$61.81	$73.51	$85.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.88 / $22.38	Professional	26	$16.60	$19.88	$22.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $44.70 / $53.37 / $62.65	Professional	TC	$44.70	$53.37	$62.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.50 / $51.70 / $94.34	Professional		$38.50	$51.70	$94.34
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $17.57 / $26.43	Professional	26	$13.88	$17.57	$26.43
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.68 / $46.20 / $70.14	Professional	TC	$31.68	$46.20	$70.14
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $11.76 / $16.07 / $17.42	Facility	26	$11.76	$16.07	$17.42
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.08 / $14.25 / $17.95	Professional	26	$10.08	$14.25	$17.95
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $33.00 / $46.95	Professional	TC	$23.72	$33.00	$46.95
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.88 / $66.72 / $89.30	Professional		$46.88	$66.72	$89.30
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.62 / $17.03 / $24.40	Professional	26	$11.62	$17.03	$24.40
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.21 / $44.96 / $63.74	Professional	TC	$27.21	$44.96	$63.74
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 $51.66 / $65.33 / $86.43	Professional		$51.66	$65.33	$86.43
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $18.07 / $24.64	Professional	26	$14.76	$18.07	$24.64
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $36.90 / $47.26 / $62.78	Professional	TC	$36.90	$47.26	$62.78
United Facility/Professional Professional Modifier Low / Median / High Price $28.03 / $31.04 / $88.76	Professional		$28.03	$31.04	$88.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $10.56 / $26.82	Professional	26	$8.59	$10.56	$26.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.41 / $25.35 / $62.03	Professional	TC	$19.41	$25.35	$62.03