Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $17.78 / $19.50	Facility	26	$12.59	$17.78	$19.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $28.18 / $61.66	Professional		$19.05	$28.18	$61.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.23 / $33.88	Professional	26	$6.03	$10.23	$33.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $18.20 / $37.15	Professional	TC	$12.88	$18.20	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $45.71 / $69.18	Professional		$23.99	$45.71	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.13 / $21.88	Professional	26	$7.94	$14.13	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $31.62 / $48.98	Professional	TC	$16.60	$31.62	$48.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $52.48 / $66.07	Professional		$45.71	$52.48	$66.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.60 / $19.95	Professional	26	$14.45	$16.60	$19.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $35.48 / $45.71	Professional	TC	$30.90	$35.48	$45.71
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $15.85 / $19.50	Facility	26	$10.72	$15.85	$19.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $42.66 / $67.61	Professional		$28.18	$42.66	$67.61
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $15.49 / $22.91	Professional	26	$8.13	$15.49	$22.91
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $32.36 / $46.77	Professional	TC	$18.62	$32.36	$46.77
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $14.79 / $15.49	Facility	26	$12.59	$14.79	$15.49
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.18 / $16.22	Professional	26	$9.33	$13.18	$16.22
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.70 / $33.11	Professional	TC	$18.62	$25.70	$33.11
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $48.98 / $70.79	Professional		$38.02	$48.98	$70.79
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.49 / $22.39	Professional	26	$10.47	$15.49	$22.39
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $31.62 / $48.98	Professional	TC	$21.88	$31.62	$48.98
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 $41.69 / $50.12 / $64.57	Professional		$41.69	$50.12	$64.57
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.85 / $20.89	Professional	26	$13.49	$15.85	$20.89
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $33.88 / $44.67	Professional	TC	$26.92	$33.88	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $28.84 / $64.57	Professional		$22.39	$28.84	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.12 / $20.42	Professional	26	$7.41	$9.12	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $19.05 / $43.65	Professional	TC	$14.45	$19.05	$43.65