Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $162.18 / $416.87	Facility		$51.29	$162.18	$416.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $21.88 / $36.31	Facility	26	$13.49	$21.88	$36.31
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $63.10 / $380.19	Facility	TC	$32.36	$63.10	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $44.67 / $147.91	Professional		$28.18	$44.67	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $14.79 / $45.71	Professional	26	$8.32	$14.79	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $27.54 / $56.23	Professional	TC	$18.20	$27.54	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $302.00 / $371.54	Facility		$25.70	$302.00	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $64.57 / $97.72	Professional		$33.88	$64.57	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $19.50 / $30.90	Professional	26	$11.48	$19.50	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $44.67 / $69.18	Professional	TC	$24.55	$44.67	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $70.79 / $89.13	Professional		$63.10	$70.79	$89.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $20.89 / $25.12	Professional	26	$18.62	$20.89	$25.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $50.12 / $64.57	Professional	TC	$44.67	$50.12	$64.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $58.88 / $363.08	Facility		$33.11	$58.88	$363.08
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $19.50 / $36.31	Facility	26	$13.49	$19.50	$36.31
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $31.62 / $54.95 / $380.19	Facility	TC	$31.62	$54.95	$380.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $61.66 / $97.72	Professional		$35.48	$61.66	$97.72
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $19.50 / $30.90	Professional	26	$10.23	$19.50	$30.90
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $44.67 / $64.57	Professional	TC	$24.55	$44.67	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $64.57 / $66.07	Facility		$48.98	$64.57	$66.07
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $19.05 / $21.38	Facility	26	$15.85	$19.05	$21.38
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $36.31 / $42.66 / $46.77	Facility	TC	$36.31	$42.66	$46.77
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.11 / $33.11	Professional		$33.11	$33.11	$33.11
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $18.20 / $22.39	Professional	26	$12.88	$18.20	$22.39
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $37.15 / $46.77	Professional	TC	$28.18	$37.15	$46.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $52.48 / $89.13	Facility		$32.36	$52.48	$89.13
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.34 / $10.96 / $15.85	Facility	26	$2.34	$10.96	$15.85
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $5.37 / $25.12 / $36.31	Facility	TC	$5.37	$25.12	$36.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $69.18 / $95.50	Professional		$52.48	$69.18	$95.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $21.88 / $29.51	Professional	26	$14.13	$21.88	$29.51
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $45.71 / $69.18	Professional	TC	$30.90	$45.71	$69.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $371.54 / $467.74	Facility		$295.12	$371.54	$467.74
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	26	$389.05	$389.05	$389.05
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	TC	$389.05	$389.05	$389.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $87.10	Professional		$57.54	$67.61	$87.10
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $21.38 / $26.30	Professional	26	$17.38	$21.38	$26.30
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $47.86 / $61.66	Professional	TC	$38.90	$47.86	$61.66
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $389.05 / $512.86	Facility		$316.23	$389.05	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $39.81 / $89.13	Professional		$31.62	$39.81	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.88 / $28.18	Professional	26	$10.23	$12.88	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $26.30 / $61.66	Professional	TC	$20.89	$26.30	$61.66