Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.99 / $18.96 / $47.22	Facility	26	$12.99	$18.96	$47.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $86.79 / $214.47	Professional		$36.67	$86.79	$214.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.17 / $12.99 / $46.00	Professional	26	$9.17	$12.99	$46.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $77.39 / $161.00	Professional	TC	$22.39	$77.39	$161.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $88.12 / $137.79	Professional		$54.60	$88.12	$137.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.65 / $18.80 / $27.53	Professional	26	$11.65	$18.80	$27.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.46 / $67.58 / $106.54	Professional	TC	$42.46	$67.58	$106.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.67 / $92.43 / $107.10	Professional		$77.67	$92.43	$107.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.89 / $21.38 / $24.07	Professional	26	$17.89	$21.38	$24.07
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 $62.98 / $81.22 / $166.98	Professional		$62.98	$81.22	$166.98
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.95 / $19.44 / $28.47	Professional	26	$14.95	$19.44	$28.47
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.03 / $68.11 / $95.48	Professional	TC	$48.03	$68.11	$95.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $14.21 / $18.46 / $19.43	Facility	26	$14.21	$18.46	$19.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $40.86 / $63.98	Professional		$40.86	$40.86	$63.98
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $12.32 / $17.26 / $20.59	Professional	26	$12.32	$17.26	$20.59
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $39.67 / $59.63 / $123.55	Professional	TC	$39.67	$59.63	$123.55
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.43 / $88.33 / $114.50	Professional		$66.43	$88.33	$114.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.68 / $19.47 / $27.53	Professional	26	$12.68	$19.47	$27.53
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $42.90 / $67.58 / $100.55	Professional	TC	$42.90	$67.58	$100.55
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 $68.23 / $88.32 / $108.02	Professional		$68.23	$88.32	$108.02
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.76 / $19.95 / $26.53	Professional	26	$16.76	$19.95	$26.53
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $51.47 / $65.87 / $81.48	Professional	TC	$51.47	$65.87	$81.48
United Facility/Professional Professional Modifier Low / Median / High Price $29.24 / $56.93 / $120.15	Professional		$29.24	$56.93	$120.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $10.39 / $28.91	Professional	26	$7.38	$10.39	$28.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.86 / $43.15 / $90.63	Professional	TC	$21.86	$43.15	$90.63