Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.14 / $129.50 / $331.34	Facility		$51.14	$129.50	$331.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.63 / $18.84 / $42.22	Facility	26	$11.63	$18.84	$42.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.85 / $56.27 / $321.10	Facility	TC	$34.85	$56.27	$321.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.46 / $43.30 / $142.01	Professional		$26.46	$43.30	$142.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $11.59 / $38.84	Professional	26	$7.33	$11.59	$38.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $28.03 / $62.85	Professional	TC	$19.14	$28.03	$62.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.63 / $223.86 / $304.19	Facility		$26.63	$223.86	$304.19
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 $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.15 / $57.14 / $90.36	Professional		$31.15	$57.14	$90.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $16.37 / $24.12	Professional	26	$9.31	$16.37	$24.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.05 / $43.14 / $68.45	Professional	TC	$23.05	$43.14	$68.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.44 / $76.69 / $88.79	Professional		$64.44	$76.69	$88.79
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 $47.99 / $57.30 / $67.27	Professional	TC	$47.99	$57.30	$67.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.54 / $56.16 / $79.59	Facility		$28.54	$56.16	$79.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.87 / $55.48 / $97.35	Professional		$46.87	$55.48	$97.35
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 $38.94 / $48.16 / $74.22	Professional	TC	$38.94	$48.16	$74.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.28 / $55.61 / $65.66	Facility		$38.28	$55.61	$65.66
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $12.25 / $16.25 / $16.75	Facility	26	$12.25	$16.25	$16.75
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $30.38 / $41.61 / $48.91	Facility	TC	$30.38	$41.61	$48.91
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.05 / $14.40 / $17.63	Professional	26	$10.05	$14.40	$17.63
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $25.33 / $33.60 / $46.62	Professional	TC	$25.33	$33.60	$46.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.47 / $68.84 / $96.47	Facility		$32.47	$68.84	$96.47
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 $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $67.94 / $92.36	Professional		$47.55	$67.94	$92.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.25 / $16.77 / $24.58	Professional	26	$11.25	$16.77	$24.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.58 / $47.02 / $68.45	Professional	TC	$29.58	$47.02	$68.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $201.89 / $281.32 / $339.89	Facility		$201.89	$281.32	$339.89
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $209.36 / $209.36 / $209.36	Facility	26	$209.36	$209.36	$209.36
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $209.36 / $209.36 / $209.36	Facility	TC	$209.36	$209.36	$209.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $53.68 / $67.54 / $89.16	Professional		$53.68	$67.54	$89.16
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.96 / $17.69 / $23.69	Professional	26	$14.96	$17.69	$23.69
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $38.13 / $50.01 / $66.42	Professional	TC	$38.13	$50.01	$66.42
United Facility/Professional Professional Modifier Low / Median / High Price $28.03 / $37.79 / $90.82	Professional		$28.03	$37.79	$90.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $11.18 / $27.66	Professional	26	$8.57	$11.18	$27.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.38 / $26.63 / $65.13	Professional	TC	$19.38	$26.63	$65.13