Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.10 / $26.41 / $52.89	Professional		$22.10	$26.41	$52.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $19.86 / $40.46	Professional	26	$16.57	$19.86	$40.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.43 / $6.69 / $12.43	Professional	TC	$5.43	$6.69	$12.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.56 / $32.25 / $49.46	Professional		$13.56	$32.25	$49.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $23.90 / $36.95	Professional	26	$10.51	$23.90	$36.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.26 / $8.35 / $12.85	Professional	TC	$3.26	$8.35	$12.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.46 / $58.95 / $84.03	Professional		$28.46	$58.95	$84.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.17 / $41.78 / $59.55	Professional	26	$20.17	$41.78	$59.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $8.28 / $17.17 / $24.48	Professional	TC	$8.28	$17.17	$24.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.89 / $52.11 / $94.43	Professional		$40.89	$52.11	$94.43
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.37 / $36.89 / $66.84	Professional	26	$30.37	$36.89	$66.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.53 / $15.22 / $27.58	Professional	TC	$12.53	$15.22	$27.58
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $31.49 / $41.78 / $43.55	Facility	26	$31.49	$41.78	$43.55
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $21.20 / $30.52 / $50.09	Professional	26	$21.20	$30.52	$50.09
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $7.18 / $9.21 / $17.22	Professional	TC	$7.18	$9.21	$17.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.25 / $56.55 / $83.79	Professional		$32.25	$56.55	$83.79
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.93 / $23.90 / $38.99	Professional	26	$12.93	$23.90	$38.99
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $4.44 / $8.35 / $14.69	Professional	TC	$4.44	$8.35	$14.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $52.07 / $57.26 / $93.98	Professional		$52.07	$57.26	$93.98
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $37.71 / $42.95 / $67.28	Professional	26	$37.71	$42.95	$67.28
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $14.32 / $15.12 / $26.70	Professional	TC	$14.32	$15.12	$26.70
United Facility/Professional Professional Modifier Low / Median / High Price $18.19 / $30.32 / $91.69	Professional		$18.19	$30.32	$91.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $22.42 / $66.41	Professional	26	$13.80	$22.42	$66.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.33 / $8.52 / $25.28	Professional	TC	$4.33	$8.52	$25.28