Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.30 / $19.63 / $44.06	Facility	26	$15.30	$19.63	$44.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.69 / $32.72 / $151.59	Professional		$19.69	$32.72	$151.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $10.31 / $39.38	Professional	26	$7.25	$10.31	$39.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.94 / $52.94 / $52.94	Professional	50	$52.94	$52.94	$52.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.09 / $22.05 / $51.62	Professional	TC	$12.09	$22.05	$51.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.96 / $9.96 / $9.96	Facility	26	$9.96	$9.96	$9.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $53.94 / $79.26	Professional		$32.15	$53.94	$79.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.72 / $17.05 / $25.27	Professional	26	$9.72	$17.05	$25.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $37.07 / $51.76	Professional	TC	$21.32	$37.07	$51.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.27 / $56.15 / $64.70	Professional		$47.27	$56.15	$64.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.95 / $22.46	Professional	26	$16.60	$19.95	$22.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.16 / $36.01 / $42.27	Professional	TC	$30.16	$36.01	$42.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.43 / $50.40 / $71.25	Professional		$38.43	$50.40	$71.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $17.75 / $26.43	Professional	26	$13.88	$17.75	$26.43
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $34.02 / $45.75	Professional	TC	$24.55	$34.02	$45.75
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $12.74 / $17.11 / $17.68	Facility	26	$12.74	$17.11	$17.68
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.45 / $15.68 / $18.48	Professional	26	$10.45	$15.68	$18.48
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $23.76 / $33.72 / $41.58	Professional	TC	$23.76	$33.72	$41.58
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.96 / $9.96 / $9.96	Facility	26	$9.96	$9.96	$9.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $41.81 / $56.80 / $72.95	Professional		$41.81	$56.80	$72.95
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $17.48 / $25.57	Professional	26	$11.78	$17.48	$25.57
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $22.10 / $37.22 / $54.85	Professional	TC	$22.10	$37.22	$54.85
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 $42.49 / $57.73 / $70.42	Professional		$42.49	$57.73	$70.42
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.56 / $18.48 / $24.64	Professional	26	$15.56	$18.48	$24.64
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $26.93 / $36.90 / $45.28	Professional	TC	$26.93	$36.90	$45.28
United Facility/Professional Professional Modifier Low / Median / High Price $28.13 / $33.53 / $78.56	Professional		$28.13	$33.53	$78.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.38 / $26.83	Professional	26	$9.33	$10.38	$26.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.38 / $22.93 / $49.95	Professional	TC	$18.38	$22.93	$49.95