Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $18.20 / $21.38	Facility	26	$13.49	$18.20	$21.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $36.31 / $95.50	Professional		$25.70	$36.31	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $20.89	Professional	26	$6.03	$8.91	$20.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $24.55 / $51.29	Professional	TC	$16.98	$24.55	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $61.66 / $95.50	Professional		$29.51	$61.66	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.49 / $24.55	Professional	26	$8.91	$15.49	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $45.71 / $72.44	Professional	TC	$20.89	$45.71	$72.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $72.44 / $91.20	Professional		$64.57	$72.44	$91.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $17.78 / $21.38	Professional	26	$15.85	$17.78	$21.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $54.95 / $70.79	Professional	TC	$48.98	$54.95	$70.79
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $20.42 / $20.42	Facility	26	$13.80	$20.42	$20.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $61.66 / $97.72	Professional		$36.31	$61.66	$97.72
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $16.98 / $25.12	Professional	26	$8.91	$16.98	$25.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $48.98 / $72.44	Professional	TC	$23.99	$48.98	$72.44
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $16.22 / $16.60	Facility	26	$13.18	$16.22	$16.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Professional		$31.62	$31.62	$31.62
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.45 / $17.78	Professional	26	$10.00	$14.45	$17.78
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $35.48 / $43.65	Professional	TC	$25.70	$35.48	$43.65
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $66.07 / $95.50	Professional		$50.12	$66.07	$95.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $16.98 / $23.99	Professional	26	$11.48	$16.98	$23.99
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $45.71 / $72.44	Professional	TC	$29.51	$45.71	$72.44
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 $54.95 / $67.61 / $87.10	Professional		$54.95	$67.61	$87.10
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $17.38 / $21.88	Professional	26	$14.45	$17.38	$21.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $50.12 / $66.07	Professional	TC	$37.15	$50.12	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $37.15 / $87.10	Professional		$28.18	$37.15	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.47 / $22.91	Professional	26	$8.32	$10.47	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.30 / $66.07	Professional	TC	$19.50	$26.30	$66.07