Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.67 / $18.09 / $40.54	Facility	26	$13.67	$18.09	$40.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.75 / $47.62 / $116.23	Facility	TC	$36.75	$47.62	$116.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.57 / $30.71 / $148.00	Professional		$23.57	$30.71	$148.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.51 / $8.63 / $22.28	Professional	26	$6.51	$8.63	$22.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.72 / $21.73 / $53.27	Professional	TC	$15.72	$21.73	$53.27
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 $24.18 / $24.18 / $24.18	Facility	TC	$24.18	$24.18	$24.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.34 / $54.79 / $81.95	Professional		$30.34	$54.79	$81.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $15.71 / $23.14	Professional	26	$9.27	$15.71	$23.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.05 / $38.56 / $60.92	Professional	TC	$21.05	$38.56	$60.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.49 / $69.61 / $80.54	Professional		$58.49	$69.61	$80.54
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 $42.71 / $51.00 / $59.87	Professional	TC	$42.71	$51.00	$59.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $45.92 / $51.82 / $89.46	Professional		$45.92	$51.82	$89.46
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $16.66 / $24.39	Professional	26	$12.80	$16.66	$24.39
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.70 / $45.85 / $68.34	Professional	TC	$34.70	$45.85	$68.34
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $11.63 / $15.78 / $16.07	Facility	26	$11.63	$15.78	$16.07
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $26.65 / $39.09 / $42.88	Facility	TC	$26.65	$39.09	$42.88
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $13.19 / $16.55	Professional	26	$9.65	$13.19	$16.55
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $25.08 / $35.20 / $42.88	Professional	TC	$25.08	$35.20	$42.88
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 $24.18 / $24.18 / $24.18	Facility	TC	$24.18	$24.18	$24.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.02 / $63.08 / $84.39	Professional		$46.02	$63.08	$84.39
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.81 / $16.34 / $23.60	Professional	26	$10.81	$16.34	$23.60
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.54 / $42.22 / $60.92	Professional	TC	$28.54	$42.22	$60.92
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 $47.97 / $61.16 / $80.58	Professional		$47.97	$61.16	$80.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $17.05 / $22.74	Professional	26	$14.36	$17.05	$22.74
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $33.21 / $44.48 / $58.23	Professional	TC	$33.21	$44.48	$58.23
United Facility/Professional Professional Modifier Low / Median / High Price $28.03 / $31.98 / $84.74	Professional		$28.03	$31.98	$84.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $11.26 / $24.57	Professional	26	$8.61	$11.26	$24.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.41 / $21.30 / $59.94	Professional	TC	$19.41	$21.30	$59.94