Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $234.42 / $363.08	Facility		$50.12	$234.42	$363.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $16.60 / $21.38	Facility	26	$10.72	$16.60	$21.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $66.07 / $323.59	Facility	TC	$33.11	$66.07	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $38.90 / $112.20	Professional		$10.96	$38.90	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $12.30 / $42.66	Professional	26	$7.24	$12.30	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $21.88 / $77.62 / $229.09	Professional	50	$21.88	$77.62	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $33.11 / $64.57	Professional	TC	$18.20	$33.11	$64.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $239.88 / $302.00	Facility		$26.30	$239.88	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $58.88 / $89.13	Professional		$28.18	$58.88	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.79 / $23.44	Professional	26	$8.91	$14.79	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $43.65 / $69.18	Professional	TC	$20.42	$43.65	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $67.61 / $85.11	Professional		$60.26	$67.61	$85.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.60 / $19.95	Professional	26	$14.45	$16.60	$19.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $51.29 / $66.07	Professional	TC	$45.71	$51.29	$66.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $54.95 / $316.23	Facility		$30.20	$54.95	$316.23
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $15.14 / $24.55	Facility	26	$10.72	$15.14	$24.55
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $57.54 / $323.59	Facility	TC	$33.11	$57.54	$323.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $50.12 / $93.33	Professional		$21.38	$50.12	$93.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $15.14 / $24.55	Professional	26	$8.32	$15.14	$24.55
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $21.88 / $77.62 / $257.04	Professional	50	$21.88	$77.62	$257.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $45.71 / $67.61	Professional	TC	$23.99	$45.71	$67.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $56.23 / $63.10	Facility		$39.81	$56.23	$63.10
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $15.14 / $16.22	Facility	26	$12.59	$15.14	$16.22
Pacific Source Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $39.81 / $47.86	Facility	TC	$32.36	$39.81	$47.86
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.13 / $17.38	Professional	26	$9.33	$14.13	$17.38
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.11 / $42.66	Professional	TC	$23.99	$33.11	$42.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $46.77 / $79.43	Facility		$30.20	$46.77	$79.43
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $37.15	Facility	TC	$5.62	$26.30	$37.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $63.10 / $91.20	Professional		$46.77	$63.10	$91.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $16.98 / $22.91	Professional	26	$10.72	$16.98	$22.91
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $43.65 / $69.18	Professional	TC	$27.54	$43.65	$69.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $281.84 / $354.81	Facility		$204.17	$281.84	$354.81
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	26	$208.93	$208.93	$208.93
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	TC	$208.93	$208.93	$208.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $83.18	Professional		$50.12	$64.57	$83.18
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.22 / $20.89	Professional	26	$13.80	$16.22	$20.89
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $47.86 / $63.10	Professional	TC	$34.67	$47.86	$63.10
United Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $323.59 / $426.58	Facility		$263.03	$323.59	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $35.48 / $83.18	Professional		$26.92	$35.48	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.23 / $21.38	Professional	26	$7.94	$10.23	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.12 / $63.10	Professional	TC	$18.20	$25.12	$63.10