Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $53.70 / $61.66	Facility	26	$39.81	$53.70	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $72.44 / $154.88	Professional		$41.69	$72.44	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $32.36 / $97.72	Professional	26	$23.44	$32.36	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $43.65 / $83.18	Professional	TC	$16.98	$43.65	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $97.72 / $158.49	Professional		$61.66	$97.72	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $50.12 / $75.86	Professional	26	$33.11	$50.12	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $42.66 / $81.28	Professional	TC	$25.12	$42.66	$81.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $93.33 / $109.65	Professional		$43.65	$93.33	$109.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $54.95 / $63.10	Professional	26	$24.55	$54.95	$63.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $38.90 / $47.86	Professional	TC	$18.62	$38.90	$47.86
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $54.95 / $54.95	Facility	26	$48.98	$54.95	$54.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $95.50 / $141.25	Professional		$63.10	$95.50	$141.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $47.86 / $75.86	Professional	26	$30.20	$47.86	$75.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $40.74 / $93.33	Professional	TC	$28.18	$40.74	$93.33
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $46.77 / $48.98	Facility	26	$38.02	$46.77	$48.98
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $42.66 / $52.48	Professional	26	$31.62	$42.66	$52.48
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $70.79 / $97.72	Professional	TC	$30.20	$70.79	$97.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $154.88	Professional		$69.18	$102.33	$154.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $51.29 / $69.18	Professional	26	$35.48	$51.29	$69.18
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $50.12 / $104.71	Professional	TC	$29.51	$50.12	$104.71
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	26	$426.58	$426.58	$426.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $97.72 / $144.54	Professional		$72.44	$97.72	$144.54
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $50.12 / $64.57	Professional	26	$42.66	$50.12	$64.57
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.90 / $93.33	Professional	TC	$28.18	$38.90	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $97.72 / $138.04	Professional		$60.26	$97.72	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $35.48 / $69.18	Professional	26	$29.51	$35.48	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $44.67 / $70.79	Professional	TC	$29.51	$44.67	$70.79