Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.01 / $34.00 / $67.97	Facility	26	$25.01	$34.00	$67.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.97 / $75.20 / $144.27	Professional		$34.97	$75.20	$144.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $15.44 / $47.30	Professional	26	$7.78	$15.44	$47.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $63.35 / $104.66	Professional	TC	$20.72	$63.35	$104.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $93.69 / $138.90	Professional		$61.75	$93.69	$138.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.17 / $24.50 / $42.09	Professional	26	$11.17	$24.50	$42.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.35 / $69.83 / $100.53	Professional	TC	$43.35	$69.83	$100.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $100.52 / $115.82	Professional		$84.57	$100.52	$115.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.45 / $34.08 / $38.36	Professional	26	$28.45	$34.08	$38.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $55.26 / $65.98 / $77.47	Professional	TC	$55.26	$65.98	$77.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $66.08 / $84.29 / $136.87	Professional		$66.08	$84.29	$136.87
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.29 / $31.92 / $47.55	Professional	26	$15.29	$31.92	$47.55
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.83 / $63.85 / $89.12	Professional	TC	$44.83	$63.85	$89.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $14.25 / $24.20 / $29.48	Facility	26	$14.25	$24.20	$29.48
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.94 / $16.00 / $27.46	Professional	26	$10.94	$16.00	$27.46
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $37.52 / $69.76 / $118.32	Professional	TC	$37.52	$69.76	$118.32
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $71.98 / $99.84 / $129.31	Professional		$71.98	$99.84	$129.31
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.03 / $25.72 / $42.24	Professional	26	$13.03	$25.72	$42.24
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $41.89 / $69.83 / $99.17	Professional	TC	$41.89	$69.83	$99.17
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $782.93 / $782.93 / $782.93	Facility	26	$782.93	$782.93	$782.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $77.81 / $96.25 / $123.17	Professional		$77.81	$96.25	$123.17
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.38 / $31.13 / $42.20	Professional	26	$15.38	$31.13	$42.20
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $50.27 / $67.36 / $82.16	Professional	TC	$50.27	$67.36	$82.16
United Facility/Professional Professional Modifier Low / Median / High Price $42.59 / $61.37 / $138.30	Professional		$42.59	$61.37	$138.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.98 / $17.57 / $45.41	Professional	26	$8.98	$17.57	$45.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.71 / $46.89 / $89.35	Professional	TC	$26.71	$46.89	$89.35