Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.46 / $230.25 / $498.38	Facility		$41.46	$230.25	$498.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.05 / $18.88 / $42.08	Facility	26	$12.05	$18.88	$42.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.84 / $163.19 / $313.50	Facility	TC	$24.84	$163.19	$313.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $27.55 / $104.00	Professional		$17.78	$27.55	$104.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.19 / $39.00	Professional	26	$8.13	$11.19	$39.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.55 / $17.52 / $46.75	Professional	TC	$10.55	$17.52	$46.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.92 / $223.86 / $304.19	Facility		$18.92	$223.86	$304.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.79 / $43.59 / $71.43	Professional		$21.79	$43.59	$71.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.07 / $17.03 / $25.06	Professional	26	$10.07	$17.03	$25.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.22 / $28.44 / $48.64	Professional	TC	$13.22	$28.44	$48.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.24 / $60.85 / $70.20	Professional		$51.24	$60.85	$70.20
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 $34.11 / $40.72 / $47.82	Professional	TC	$34.11	$40.72	$47.82
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $21.14 / $46.49 / $200.45	Facility		$21.14	$46.49	$200.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $27.75 / $44.15 / $79.29	Professional		$27.75	$44.15	$79.29
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $19.76 / $44.15	Professional	26	$13.88	$19.76	$44.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.58 / $39.53 / $52.86	Professional	TC	$27.58	$39.53	$52.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $30.74 / $48.24 / $51.59	Facility		$30.74	$48.24	$51.59
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $11.00 / $16.75 / $17.42	Facility	26	$11.00	$16.75	$17.42
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $28.59 / $33.32 / $34.84	Facility	TC	$28.59	$33.32	$34.84
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $20.93 / $20.93 / $20.93	Professional		$20.93	$20.93	$20.93
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.05 / $13.75 / $16.75	Professional	26	$10.05	$13.75	$16.75
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $29.55 / $34.84	Professional	TC	$19.80	$29.55	$34.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $24.74 / $61.83 / $81.90	Facility		$24.74	$61.83	$81.90
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.60 / $55.44 / $74.69	Professional		$33.60	$55.44	$74.69
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $17.71 / $25.06	Professional	26	$11.69	$17.71	$25.06
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.64 / $30.87 / $48.66	Professional	TC	$15.64	$30.87	$48.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $201.89 / $281.32 / $339.89	Facility		$201.89	$281.32	$339.89
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 Facility Modifier TC Low / Median / High Price $209.36 / $209.36 / $209.36	Facility	TC	$209.36	$209.36	$209.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.43 / $56.96 / $73.90	Professional		$46.43	$56.96	$73.90
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.56 / $19.25 / $24.64	Professional	26	$15.56	$19.25	$24.64
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $30.99 / $36.14 / $49.27	Professional	TC	$30.99	$36.14	$49.27
United Facility/Professional Professional Modifier Low / Median / High Price $20.12 / $26.43 / $74.40	Professional		$20.12	$26.43	$74.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $11.62 / $26.82	Professional	26	$9.31	$11.62	$26.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.78 / $19.55 / $47.54	Professional	TC	$10.78	$19.55	$47.54