Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.08 / $22.68 / $46.95	Facility	26	$14.08	$22.68	$46.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $40.34 / $146.43	Professional		$32.86	$40.34	$146.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $13.21 / $25.77	Professional	26	$8.39	$13.21	$25.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.02 / $61.63	Professional	TC	$19.95	$28.02	$61.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.56 / $11.56 / $11.56	Facility	26	$11.56	$11.56	$11.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.76 / $67.15 / $96.58	Professional		$37.76	$67.15	$96.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $20.91 / $30.91	Professional	26	$12.42	$20.91	$30.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.46 / $45.55 / $69.40	Professional	TC	$26.46	$45.55	$69.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.44 / $81.34 / $94.06	Professional		$68.44	$81.34	$94.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.19 / $22.97 / $25.86	Professional	26	$19.19	$22.97	$25.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.66 / $58.10 / $68.20	Professional	TC	$48.66	$58.10	$68.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.76 / $64.26 / $105.72	Professional		$53.76	$64.26	$105.72
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.01 / $20.28 / $30.51	Professional	26	$16.01	$20.28	$30.51
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.50 / $51.37 / $75.23	Professional	TC	$39.50	$51.37	$75.23
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $15.19 / $19.79 / $20.77	Facility	26	$15.19	$19.79	$20.77
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $13.67 / $19.79 / $23.38	Professional	26	$13.67	$19.79	$23.38
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $26.13 / $36.85 / $49.39	Professional	TC	$26.13	$36.85	$49.39
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.56 / $11.56 / $11.56	Facility	26	$11.56	$11.56	$11.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.20 / $74.88 / $99.24	Professional		$53.20	$74.88	$99.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.59 / $21.29 / $30.91	Professional	26	$13.59	$21.29	$30.91
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $33.52 / $48.83 / $69.40	Professional	TC	$33.52	$48.83	$69.40
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 $62.24 / $72.28 / $94.86	Professional		$62.24	$72.28	$94.86
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.96 / $22.21 / $28.43	Professional	26	$17.96	$22.21	$28.43
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $44.29 / $50.69 / $67.50	Professional	TC	$44.29	$50.69	$67.50
United Facility/Professional Professional Modifier Low / Median / High Price $33.78 / $41.38 / $99.08	Professional		$33.78	$41.38	$99.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.13 / $13.40 / $31.76	Professional	26	$11.13	$13.40	$31.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.56 / $29.55 / $67.19	Professional	TC	$21.56	$29.55	$67.19