Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.94 / $24.23 / $54.05	Facility	26	$14.94	$24.23	$54.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $44.68 / $169.86	Professional		$31.42	$44.68	$169.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $14.80 / $41.97	Professional	26	$8.22	$14.80	$41.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.19 / $31.93 / $92.06	Professional	TC	$23.19	$31.93	$92.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $68.81 / $108.75	Professional		$35.47	$68.81	$108.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.46 / $18.96 / $29.72	Professional	26	$10.46	$18.96	$29.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.26 / $50.87 / $80.70	Professional	TC	$26.26	$50.87	$80.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.72 / $92.36 / $106.86	Professional		$77.72	$92.36	$106.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $24.47 / $27.55	Professional	26	$20.50	$24.47	$27.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $56.59 / $67.56 / $79.31	Professional	TC	$56.59	$67.56	$79.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.88 / $66.80 / $119.97	Professional		$54.88	$66.80	$119.97
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $20.70 / $32.52	Professional	26	$17.07	$20.70	$32.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.54 / $55.62 / $87.42	Professional	TC	$45.54	$55.62	$87.42
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $13.27 / $18.36 / $21.76	Facility	26	$13.27	$18.36	$21.76
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $11.61 / $16.20 / $21.44	Professional	26	$11.61	$16.20	$21.44
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $28.38 / $42.55 / $52.14	Professional	TC	$28.38	$42.55	$52.14
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.12 / $81.13 / $111.15	Professional		$56.12	$81.13	$111.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.65 / $20.26 / $30.04	Professional	26	$13.65	$20.26	$30.04
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $35.50 / $55.95 / $80.70	Professional	TC	$35.50	$55.95	$80.70
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 $64.00 / $80.83 / $107.36	Professional		$64.00	$80.83	$107.36
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.61 / $21.92 / $30.32	Professional	26	$16.61	$21.92	$30.32
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $47.36 / $58.91 / $78.23	Professional	TC	$47.36	$58.91	$78.23
United Facility/Professional Professional Modifier Low / Median / High Price $33.06 / $47.14 / $122.26	Professional		$33.06	$47.14	$122.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $15.49 / $33.79	Professional	26	$9.69	$15.49	$33.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.36 / $31.31 / $76.38	Professional	TC	$23.36	$31.31	$76.38