Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.65 / $19.98 / $40.39	Facility	26	$13.65	$19.98	$40.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.56 / $32.81 / $145.28	Professional		$26.56	$32.81	$145.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.62 / $9.27 / $19.97	Professional	26	$6.62	$9.27	$19.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.47 / $24.19 / $61.29	Professional	TC	$18.47	$24.19	$61.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.43 / $57.74 / $93.19	Professional		$30.43	$57.74	$93.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $16.19 / $24.10	Professional	26	$9.31	$16.19	$24.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.62 / $44.33 / $71.28	Professional	TC	$21.62	$44.33	$71.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.43 / $79.06 / $91.57	Professional		$66.43	$79.06	$91.57
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 $49.98 / $59.68 / $70.05	Professional	TC	$49.98	$59.68	$70.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $56.07 / $98.37	Professional		$42.00	$56.07	$98.37
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.35 / $16.23 / $24.39	Professional	26	$13.35	$16.23	$24.39
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.29 / $49.16 / $76.26	Professional	TC	$36.29	$49.16	$76.26
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $12.25 / $15.96 / $16.75	Facility	26	$12.25	$15.96	$16.75
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.05 / $14.75 / $18.50	Professional	26	$10.05	$14.75	$18.50
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $25.08 / $36.54 / $44.20	Professional	TC	$25.08	$36.54	$44.20
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.82 / $69.29 / $93.67	Professional		$47.82	$69.29	$93.67
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.87 / $16.77 / $24.10	Professional	26	$10.87	$16.77	$24.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.58 / $49.08 / $71.28	Professional	TC	$29.58	$49.08	$71.28
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 Professional Modifier Low / Median / High Price $54.90 / $68.50 / $90.07	Professional		$54.90	$68.50	$90.07
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $17.69 / $22.74	Professional	26	$14.36	$17.69	$22.74
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $39.65 / $51.15 / $68.23	Professional	TC	$39.65	$51.15	$68.23
United Facility/Professional Professional Modifier Low / Median / High Price $28.50 / $37.94 / $93.02	Professional		$28.50	$37.94	$93.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $11.17 / $25.52	Professional	26	$8.57	$11.17	$25.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.41 / $26.40 / $67.09	Professional	TC	$19.41	$26.40	$67.09