Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $29.51 / $281.84	Facility		$18.62	$29.51	$281.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $16.60 / $19.50	Facility	26	$10.00	$16.60	$19.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $13.49 / $50.12	Professional		$10.47	$13.49	$50.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $36.31	Professional	26	$6.03	$8.91	$36.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.48 / $11.48 / $12.30	Professional	50	$11.48	$11.48	$12.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.98 / $8.91	Professional	TC	$3.02	$3.98	$8.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3.89 / $69.18 / $85.11	Facility		$3.89	$69.18	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $22.91 / $34.67	Professional		$13.49	$22.91	$34.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.49 / $23.44	Professional	26	$9.33	$15.49	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.89 / $7.41 / $11.75	Professional	TC	$3.89	$7.41	$11.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $23.99 / $29.51	Professional		$19.50	$23.99	$29.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.22 / $19.50	Professional	26	$12.59	$16.22	$19.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $8.32 / $10.00	Professional	TC	$6.76	$8.32	$10.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $17.78 / $30.20	Facility		$10.23	$17.78	$30.20
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $13.18 / $13.18	Facility	26	$13.18	$13.18	$13.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $22.91 / $33.88	Professional		$12.30	$22.91	$33.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $15.85 / $22.91	Professional	26	$9.12	$15.85	$22.91
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $11.48 / $12.30 / $12.30	Professional	50	$11.48	$12.30	$12.30
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.27 / $7.59 / $11.75	Professional	TC	$4.27	$7.59	$11.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $21.88 / $28.84	Facility		$18.62	$21.88	$28.84
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $15.14 / $18.62	Facility	26	$12.59	$15.14	$18.62
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.49 / $19.50	Professional	26	$10.47	$15.49	$19.50
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $5.01 / $7.59 / $10.23	Professional	TC	$5.01	$7.59	$10.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $17.78 / $31.62	Facility		$11.48	$17.78	$31.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $25.70 / $33.88	Professional		$18.62	$25.70	$33.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $17.78 / $22.39	Professional	26	$11.48	$17.78	$22.39
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $5.75 / $8.51 / $12.02	Professional	TC	$5.75	$8.51	$12.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $85.11 / $112.20	Facility		$56.23	$85.11	$112.20
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	26	$58.88	$58.88	$58.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.92 / $33.11	Professional		$20.89	$26.92	$33.11
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $17.38 / $22.39	Professional	26	$14.13	$17.38	$22.39
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $8.71 / $11.48	Professional	TC	$6.76	$8.71	$11.48
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $107.15 / $141.25	Facility		$87.10	$107.15	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $15.49 / $33.11	Professional		$12.02	$15.49	$33.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.00 / $22.39	Professional	26	$8.32	$10.00	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.63 / $5.37 / $10.72	Professional	TC	$3.63	$5.37	$10.72