Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.96 / $114.37 / $378.80	Facility		$43.96	$114.37	$378.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.21 / $18.05 / $38.29	Facility	26	$13.21	$18.05	$38.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.15 / $106.99 / $467.30	Facility	TC	$36.15	$106.99	$467.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.12 / $39.86 / $114.34	Professional		$18.12	$39.86	$114.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $11.52 / $41.42	Professional	26	$6.74	$11.52	$41.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.17 / $23.06 / $53.27	Professional	TC	$17.17	$23.06	$53.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.33 / $223.86 / $304.19	Facility		$23.33	$223.86	$304.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.76 / $53.62 / $81.01	Professional		$29.76	$53.62	$81.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.26 / $15.27 / $22.53	Professional	26	$8.26	$15.27	$22.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.23 / $39.04 / $59.97	Professional	TC	$21.23	$39.04	$59.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.83 / $68.81 / $79.59	Professional		$57.83	$68.81	$79.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.31 / $18.36 / $20.67	Professional	26	$15.31	$18.36	$20.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $42.05 / $50.21 / $58.94	Professional	TC	$42.05	$50.21	$58.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $25.58 / $51.06 / $79.59	Facility		$25.58	$51.06	$79.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $49.81 / $89.46	Professional		$43.00	$49.81	$89.46
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $15.52 / $24.39	Professional	26	$12.80	$15.52	$24.39
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.15 / $41.40 / $65.06	Professional	TC	$34.15	$41.40	$65.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $37.24 / $53.60 / $58.96	Facility		$37.24	$53.60	$58.96
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $11.27 / $15.41 / $16.07	Facility	26	$11.27	$15.41	$16.07
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $29.89 / $37.52 / $42.88	Facility	TC	$29.89	$37.52	$42.88
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $13.34 / $16.57	Professional	26	$9.65	$13.34	$16.57
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $34.47 / $42.67	Professional	TC	$23.32	$34.47	$42.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.66 / $66.30 / $87.12	Facility		$30.66	$66.30	$87.12
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.84 / $62.42 / $82.65	Professional		$44.84	$62.42	$82.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.75 / $15.71 / $22.78	Professional	26	$10.75	$15.71	$22.78
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.54 / $42.10 / $59.97	Professional	TC	$28.54	$42.10	$59.97
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 $52.06 / $60.28 / $80.06	Professional		$52.06	$60.28	$80.06
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.15 / $16.68 / $22.74	Professional	26	$14.15	$16.68	$22.74
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $37.36 / $43.84 / $58.23	Professional	TC	$37.36	$43.84	$58.23
United Facility/Professional Facility Modifier Low / Median / High Price $38.54 / $38.54 / $38.54	Facility		$38.54	$38.54	$38.54
United Facility/Professional Professional Modifier Low / Median / High Price $27.67 / $35.15 / $82.68	Professional		$27.67	$35.15	$82.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.24 / $12.74 / $25.52	Professional	26	$8.24	$12.74	$25.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.10 / $57.88	Professional	TC	$19.05	$26.10	$57.88