Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.50 / $40.83 / $82.81	Facility	26	$35.50	$40.83	$82.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.49 / $49.20 / $126.66	Professional		$30.49	$49.20	$126.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.12 / $18.48 / $44.84	Professional	26	$11.12	$18.48	$44.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.72 / $30.57 / $77.34	Professional	TC	$22.72	$30.57	$77.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $18.82 / $18.82	Facility	26	$18.82	$18.82	$18.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.23 / $81.88 / $129.26	Professional		$44.23	$81.88	$129.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.84 / $31.13 / $45.99	Professional	26	$17.84	$31.13	$45.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.66 / $53.71 / $84.69	Professional	TC	$27.66	$53.71	$84.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.45 / $108.53 / $125.22	Professional		$91.45	$108.53	$125.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.27 / $37.47 / $42.19	Professional	26	$31.27	$37.47	$42.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $59.22 / $70.70 / $83.03	Professional	TC	$59.22	$70.70	$83.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.04 / $78.68 / $143.34	Professional		$61.04	$78.68	$143.34
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.15 / $34.00 / $51.99	Professional	26	$26.15	$34.00	$51.99
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.03 / $63.00 / $93.54	Professional	TC	$48.03	$63.00	$93.54
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $22.54 / $31.24 / $32.83	Facility	26	$22.54	$31.24	$32.83
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $19.30 / $27.98 / $33.58	Professional	26	$19.30	$27.98	$33.58
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $26.53 / $38.00 / $51.36	Professional	TC	$26.53	$38.00	$51.36
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $18.82 / $18.82	Facility	26	$18.82	$18.82	$18.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $95.46 / $133.00	Professional		$64.05	$95.46	$133.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.20 / $32.08 / $47.33	Professional	26	$22.20	$32.08	$47.33
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $32.39 / $59.44 / $86.34	Professional	TC	$32.39	$59.44	$86.34
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $385.75 / $385.75 / $385.75	Facility	26	$385.75	$385.75	$385.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $96.57 / $128.37	Professional		$75.03	$96.57	$128.37
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $29.33 / $34.06 / $46.43	Professional	26	$29.33	$34.06	$46.43
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $44.57 / $61.92 / $83.70	Professional	TC	$44.57	$61.92	$83.70
United Facility/Professional Professional Modifier Low / Median / High Price $38.09 / $55.75 / $133.35	Professional		$38.09	$55.75	$133.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.47 / $17.68 / $50.56	Professional	26	$16.47	$17.68	$50.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.17 / $32.77 / $82.58	Professional	TC	$21.17	$32.77	$82.58