Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.42 / $14.43 / $31.24	Facility	26	$9.42	$14.43	$31.24
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $45.77 / $86.00 / $304.00	Facility	TC	$45.77	$86.00	$304.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $46.90 / $147.00	Professional		$26.88	$46.90	$147.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.08 / $11.35 / $35.83	Professional	26	$6.08	$11.35	$35.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $156.44 / $156.44 / $156.44	Professional	50	$156.44	$156.44	$156.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.22 / $19.98 / $52.25	Professional	52	$12.22	$19.98	$52.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $42.93 / $92.48	Professional	TC	$22.57	$42.93	$92.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $7.66	Facility	26	$7.66	$7.66	$7.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	TC	$35.40	$35.40	$35.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.43 / $66.80 / $106.69	Professional		$33.43	$66.80	$106.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $13.04 / $19.25	Professional	26	$7.36	$13.04	$19.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.10 / $54.08 / $89.19	Professional	TC	$26.10	$54.08	$89.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.62 / $90.22 / $104.84	Professional		$75.62	$90.22	$104.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.72 / $15.27 / $17.19	Professional	26	$12.72	$15.27	$17.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $62.53 / $74.67 / $87.65	Professional	TC	$62.53	$74.67	$87.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $64.26 / $115.89	Professional		$48.00	$64.26	$115.89
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $12.94 / $20.34	Professional	26	$10.68	$12.94	$20.34
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.29 / $61.44 / $95.55	Professional	TC	$36.29	$61.44	$95.55
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $9.80 / $13.00 / $13.40	Facility	26	$9.80	$13.00	$13.40
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $33.43 / $53.60 / $63.65	Facility	TC	$33.43	$53.60	$63.65
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $8.03 / $11.80 / $14.05	Professional	26	$8.03	$11.80	$14.05
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $30.15 / $43.07 / $53.60	Professional	TC	$30.15	$43.07	$53.60
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $7.66	Facility	26	$7.66	$7.66	$7.66
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	TC	$35.40	$35.40	$35.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $78.95 / $106.69	Professional		$54.60	$78.95	$106.69
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.05 / $13.26 / $19.67	Professional	26	$9.05	$13.26	$19.67
Providence Facility/Professional Professional Modifier 52 Low / Median / High Price $41.04 / $43.37 / $43.37	Professional	52	$41.04	$43.37	$43.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $34.94 / $60.75 / $89.19	Professional	TC	$34.94	$60.75	$89.19
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 $60.89 / $78.77 / $103.72	Professional		$60.89	$78.77	$103.72
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.97 / $14.15 / $18.95	Professional	26	$11.97	$14.15	$18.95
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $48.59 / $65.08 / $85.52	Professional	TC	$48.59	$65.08	$85.52
United Facility/Professional Professional Modifier Low / Median / High Price $31.26 / $46.92 / $107.84	Professional		$31.26	$46.92	$107.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $7.88 / $21.09	Professional	26	$7.16	$7.88	$21.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.07 / $47.41 / $82.68	Professional	TC	$24.07	$47.41	$82.68