Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.94 / $114.97 / $326.82	Facility		$39.94	$114.97	$326.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $18.12 / $39.07	Facility	26	$11.75	$18.12	$39.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.96 / $43.82 / $414.90	Facility	TC	$26.96	$43.82	$414.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.30 / $32.19 / $107.69	Professional		$24.30	$32.19	$107.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $12.05 / $39.00	Professional	26	$7.95	$12.05	$39.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.80 / $21.92 / $55.98	Professional	TC	$15.80	$21.92	$55.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.49 / $301.52 / $367.38	Facility		$21.49	$301.52	$367.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $22.00 / $22.00 / $22.00	Facility	TC	$22.00	$22.00	$22.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.72 / $56.49 / $83.12	Professional		$29.72	$56.49	$83.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.72 / $16.37 / $24.30	Professional	26	$9.72	$16.37	$24.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.59 / $41.20 / $58.02	Professional	TC	$20.59	$41.20	$58.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.20 / $65.62 / $75.84	Professional		$55.20	$65.62	$75.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $19.12 / $21.52	Professional	26	$15.96	$19.12	$21.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.75 / $46.27 / $54.31	Professional	TC	$38.75	$46.27	$54.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $24.42 / $50.33 / $78.20	Facility		$24.42	$50.33	$78.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.50 / $50.16 / $85.41	Professional		$39.50	$50.16	$85.41
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.35 / $16.18 / $25.41	Professional	26	$13.35	$16.18	$25.41
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.48 / $39.00 / $59.97	Professional	TC	$31.48	$39.00	$59.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.69 / $53.60 / $60.30	Facility		$39.69	$53.60	$60.30
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $12.25 / $16.45 / $17.00	Facility	26	$12.25	$16.45	$17.00
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $30.78 / $37.04 / $39.53	Facility	TC	$30.78	$37.04	$39.53
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.85 / $15.93 / $18.75	Professional	26	$10.85	$15.93	$18.75
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $23.62 / $32.89 / $43.55	Professional	TC	$23.62	$32.89	$43.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $29.75 / $64.28 / $82.90	Facility		$29.75	$64.28	$82.90
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $22.00 / $22.00 / $22.00	Facility	TC	$22.00	$22.00	$22.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.99 / $61.09 / $81.48	Professional		$47.99	$61.09	$81.48
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.33 / $16.98 / $24.58	Professional	26	$11.33	$16.98	$24.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $26.27 / $43.60 / $63.18	Professional	TC	$26.27	$43.60	$63.18
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 $49.61 / $62.19 / $79.59	Professional		$49.61	$62.19	$79.59
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.96 / $17.77 / $23.69	Professional	26	$14.96	$17.77	$23.69
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $34.29 / $43.68 / $55.90	Professional	TC	$34.29	$43.68	$55.90
United Facility/Professional Professional Modifier Low / Median / High Price $27.67 / $34.56 / $82.68	Professional		$27.67	$34.56	$82.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $10.64 / $25.80	Professional	26	$8.94	$10.64	$25.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.36 / $24.63 / $57.76	Professional	TC	$18.36	$24.63	$57.76