Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.69 / $144.41 / $309.87	Facility		$49.69	$144.41	$309.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.11 / $16.16 / $35.86	Facility	26	$11.11	$16.16	$35.86
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.52 / $56.27 / $399.00	Facility	TC	$40.52	$56.27	$399.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $38.59 / $121.70	Professional		$19.17	$38.59	$121.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.19 / $11.12 / $44.56	Professional	26	$7.19	$11.12	$44.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $27.11 / $61.71	Professional	TC	$18.82	$27.11	$61.71
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 $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
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 $31.46 / $57.13 / $88.55	Professional		$31.46	$57.13	$88.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.72 / $15.71 / $23.14	Professional	26	$9.72	$15.71	$23.14
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 $63.11 / $75.14 / $87.03	Professional		$63.11	$75.14	$87.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.67 / $17.55 / $19.76	Professional	26	$14.67	$17.55	$19.76
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 $27.94 / $56.58 / $81.75	Facility		$27.94	$56.58	$81.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.20 / $54.34 / $95.35	Professional		$47.20	$54.34	$95.35
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $16.07 / $24.39	Professional	26	$12.28	$16.07	$24.39
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.28 / $47.20 / $74.22	Professional	TC	$38.28	$47.20	$74.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.69 / $55.61 / $64.31	Facility		$39.69	$55.61	$64.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $11.76 / $15.11 / $16.25	Facility	26	$11.76	$15.11	$16.25
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $29.89 / $42.84 / $48.91	Facility	TC	$29.89	$42.84	$48.91
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.05 / $14.68 / $17.52	Professional	26	$10.05	$14.68	$17.52
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $25.73 / $35.88 / $45.82	Professional	TC	$25.73	$35.88	$45.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.13 / $70.55 / $96.51	Facility		$32.13	$70.55	$96.51
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
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 $47.79 / $67.20 / $91.20	Professional		$47.79	$67.20	$91.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.42 / $15.97 / $23.14	Professional	26	$10.42	$15.97	$23.14
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.37 / $47.71 / $68.45	Professional	TC	$30.37	$47.71	$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 / $66.72 / $88.25	Professional		$53.68	$66.72	$88.25
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $16.98 / $22.74	Professional	26	$14.36	$16.98	$22.74
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $38.43 / $50.01 / $66.42	Professional	TC	$38.43	$50.01	$66.42
United Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $38.35 / $90.96	Professional		$29.00	$38.35	$90.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.25 / $24.76	Professional	26	$8.51	$10.25	$24.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.41 / $27.45 / $66.06	Professional	TC	$20.41	$27.45	$66.06