Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $115.50 / $322.56	Professional		$76.06	$115.50	$322.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.12 / $21.11 / $48.73	Professional	26	$13.12	$21.11	$48.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.11 / $97.09 / $273.85	Professional	TC	$60.11	$97.09	$273.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.20 / $196.48 / $323.18	Professional		$89.20	$196.48	$323.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.97 / $34.77 / $52.94	Professional	26	$20.97	$34.77	$52.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.13 / $164.56 / $274.17	Professional	TC	$73.13	$164.56	$274.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $217.01 / $258.61 / $300.83	Professional		$217.01	$258.61	$300.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.79 / $42.91 / $48.32	Professional	26	$35.79	$42.91	$48.32
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $180.12 / $215.07 / $252.54	Professional	TC	$180.12	$215.07	$252.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $111.74 / $180.81 / $349.06	Professional		$111.74	$180.81	$349.06
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.88 / $36.85 / $57.96	Professional	26	$29.88	$36.85	$57.96
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.36 / $160.72 / $289.66	Professional	TC	$96.36	$160.72	$289.66
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $33.04 / $39.36	Professional	26	$22.91	$33.04	$39.36
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $80.37 / $117.89 / $180.12	Professional	TC	$80.37	$117.89	$180.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $146.18 / $235.40 / $330.60	Professional		$146.18	$235.40	$330.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.42 / $36.81 / $53.50	Professional	26	$25.42	$36.81	$53.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $97.52 / $180.80 / $279.50	Professional	TC	$97.52	$180.80	$279.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $161.13 / $240.96 / $320.25	Professional		$161.13	$240.96	$320.25
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $39.61 / $53.41	Professional	26	$33.54	$39.61	$53.41
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $132.47 / $199.88 / $268.39	Professional	TC	$132.47	$199.88	$268.39
United Facility/Professional Professional Modifier Low / Median / High Price $85.77 / $117.84 / $315.77	Professional		$85.77	$117.84	$315.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.48 / $25.34 / $55.73	Professional	26	$19.48	$25.34	$55.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.15 / $99.96 / $260.05	Professional	TC	$71.15	$99.96	$260.05