Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.58 / $163.28 / $406.81	Facility		$51.58	$163.28	$406.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.52 / $21.92 / $45.39	Facility	26	$13.52	$21.92	$45.39
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.15 / $59.54 / $380.00	Facility	TC	$39.15	$59.54	$380.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $45.30 / $148.16	Professional		$30.73	$45.30	$148.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $14.47 / $49.00	Professional	26	$8.69	$14.47	$49.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.22 / $26.00 / $58.57	Professional	TC	$17.22	$26.00	$58.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.53 / $301.52 / $367.38	Facility		$25.53	$301.52	$367.38
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 Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.56 / $64.06 / $94.83	Professional		$36.56	$64.06	$94.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.01 / $20.22 / $30.62	Professional	26	$12.01	$20.22	$30.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.86 / $44.38 / $65.63	Professional	TC	$25.86	$44.38	$65.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.12 / $77.41 / $89.49	Professional		$65.12	$77.41	$89.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.55 / $22.21 / $25.00	Professional	26	$18.55	$22.21	$25.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $54.93 / $64.48	Professional	TC	$46.00	$54.93	$64.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.87 / $59.13 / $84.89	Facility		$28.87	$59.13	$84.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.18 / $100.65	Professional		$50.00	$60.18	$100.65
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.48 / $19.80 / $29.49	Professional	26	$15.48	$19.80	$29.49
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.36 / $45.73 / $71.16	Professional	TC	$37.36	$45.73	$71.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.51 / $60.92 / $66.33	Facility		$46.51	$60.92	$66.33
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $15.68 / $19.12 / $21.44	Facility	26	$15.68	$19.12	$21.44
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $33.32 / $42.29 / $46.90	Facility	TC	$33.32	$42.29	$46.90
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $17.94 / $21.78	Professional	26	$12.86	$17.94	$21.78
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $25.73 / $37.32 / $46.01	Professional	TC	$25.73	$37.32	$46.01
Providence Facility/Professional Facility Modifier Low / Median / High Price $34.65 / $75.89 / $97.40	Facility		$34.65	$75.89	$97.40
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 Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.39 / $70.79 / $95.06	Professional		$53.39	$70.79	$95.06
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.14 / $20.76 / $30.91	Professional	26	$13.14	$20.76	$30.91
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $31.26 / $46.40 / $65.84	Professional	TC	$31.26	$46.40	$65.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $312.19 / $372.00 / $463.05	Facility		$312.19	$372.00	$463.05
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $385.75 / $385.75 / $385.75	Facility	26	$385.75	$385.75	$385.75
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $385.75 / $385.75 / $385.75	Facility	TC	$385.75	$385.75	$385.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $59.25 / $68.80 / $90.07	Professional		$59.25	$68.80	$90.07
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.36 / $21.47 / $27.48	Professional	26	$17.36	$21.47	$27.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $40.96 / $48.31 / $63.69	Professional	TC	$40.96	$48.31	$63.69
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.35 / $109.55	Professional		$31.62	$44.35	$109.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $12.61 / $29.99	Professional	26	$10.19	$12.61	$29.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.56 / $27.96 / $62.01	Professional	TC	$20.56	$27.96	$62.01