Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.47 / $21.96 / $47.22	Facility	26	$13.47	$21.96	$47.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $32.82 / $156.00	Professional		$24.98	$32.82	$156.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $10.38 / $24.79	Professional	26	$8.01	$10.38	$24.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.72 / $21.40 / $54.46	Professional	TC	$15.72	$21.40	$54.46
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 $32.15 / $59.00 / $88.24	Professional		$32.15	$59.00	$88.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.65 / $19.47 / $27.99	Professional	26	$11.65	$19.47	$27.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.64 / $38.39 / $63.74	Professional	TC	$20.64	$38.39	$63.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.15 / $75.04 / $86.72	Professional		$63.15	$75.04	$86.72
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 $44.70 / $53.37 / $62.65	Professional	TC	$44.70	$53.37	$62.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $55.89 / $93.33	Professional		$48.00	$55.89	$93.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.95 / $19.80 / $29.49	Professional	26	$14.95	$19.80	$29.49
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.29 / $50.82 / $66.09	Professional	TC	$36.29	$50.82	$66.09
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $15.08 / $18.46 / $20.77	Facility	26	$15.08	$18.46	$20.77
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $34.59 / $34.59 / $34.59	Professional		$34.59	$34.59	$34.59
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $12.46 / $17.67 / $21.86	Professional	26	$12.46	$17.67	$21.86
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $19.60 / $29.92 / $37.52	Professional	TC	$19.60	$29.92	$37.52
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 $46.02 / $66.50 / $89.24	Professional		$46.02	$66.50	$89.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.03 / $20.09 / $27.99	Professional	26	$13.03	$20.09	$27.99
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $26.34 / $42.91 / $64.92	Professional	TC	$26.34	$42.91	$64.92
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $209.36 / $209.36 / $209.36	Facility	26	$209.36	$209.36	$209.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $51.85 / $66.51 / $87.27	Professional		$51.85	$66.51	$87.27
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.36 / $20.66 / $27.48	Professional	26	$17.36	$20.66	$27.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $32.33 / $45.99 / $59.46	Professional	TC	$32.33	$45.99	$59.46
United Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $36.11 / $93.91	Professional		$20.72	$36.11	$93.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.64 / $12.97 / $30.86	Professional	26	$7.64	$12.97	$30.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $24.60 / $63.97	Professional	TC	$12.59	$24.60	$63.97