Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $26.92 / $34.67	Facility	26	$17.38	$26.92	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $75.86 / $229.09	Professional		$50.12	$75.86	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $20.42 / $42.66	Professional	26	$12.02	$20.42	$42.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $51.29 / $91.20	Professional	TC	$32.36	$51.29	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $102.33 / $147.91	Professional		$53.70	$102.33	$147.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $26.30 / $43.65	Professional	26	$15.85	$26.30	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $74.13 / $112.20	Professional	TC	$37.15	$74.13	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $114.82 / $141.25	Professional		$102.33	$114.82	$141.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $26.92 / $33.11	Professional	26	$23.99	$26.92	$33.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $87.10 / $109.65	Professional	TC	$79.43	$87.10	$109.65
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $25.12 / $34.67	Facility	26	$17.38	$25.12	$34.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $95.50 / $154.88	Professional		$56.23	$95.50	$154.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $25.70 / $40.74	Professional	26	$14.13	$25.70	$40.74
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $74.13 / $109.65	Professional	TC	$41.69	$74.13	$109.65
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $24.55 / $30.20	Facility	26	$20.42	$24.55	$30.20
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $25.12 / $30.90	Professional	26	$18.20	$25.12	$30.90
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $60.26 / $79.43	Professional	TC	$41.69	$60.26	$79.43
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $151.36	Professional		$81.28	$104.71	$151.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $29.51 / $38.90	Professional	26	$19.50	$29.51	$38.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $74.13 / $112.20	Professional	TC	$51.29	$74.13	$112.20
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 Professional Modifier Low / Median / High Price $89.13 / $104.71 / $134.90	Professional		$89.13	$104.71	$134.90
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $28.84 / $35.48	Professional	26	$22.39	$28.84	$35.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $77.62 / $102.33	Professional	TC	$60.26	$77.62	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $61.66 / $134.90	Professional		$48.98	$61.66	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $16.98 / $38.02	Professional	26	$13.18	$16.98	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $43.65 / $102.33	Professional	TC	$33.11	$43.65	$102.33