Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $28.84 / $194.98	Facility		$27.54	$28.84	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $15.14 / $31.62	Professional		$12.59	$15.14	$31.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $6.92 / $13.49	Professional	26	$3.02	$6.92	$13.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.94 / $10.96 / $23.44	Professional	TC	$7.94	$10.96	$23.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $19.50 / $19.50	Facility		$19.50	$19.50	$19.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $14.79 / $31.62	Professional		$8.51	$14.79	$31.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.14 / $3.63 / $7.08	Professional	26	$2.14	$3.63	$7.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $6.03 / $11.22 / $20.89	Professional	TC	$6.03	$11.22	$20.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $32.36 / $45.71	Professional		$16.22	$32.36	$45.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $8.51 / $12.02	Professional	26	$4.27	$8.51	$12.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $23.99 / $33.88	Professional	TC	$11.75	$23.99	$33.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $24.55 / $53.70	Facility		$12.02	$24.55	$53.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $30.90 / $52.48	Professional		$16.60	$30.90	$52.48
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $7.94 / $14.45	Professional	26	$4.27	$7.94	$14.45
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $24.55 / $37.15	Professional	TC	$11.48	$24.55	$37.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $30.90 / $38.90	Facility		$26.30	$30.90	$38.90
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $8.51 / $8.71	Facility	26	$7.08	$8.51	$8.71
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $5.25 / $6.46 / $8.71	Professional	26	$5.25	$6.46	$8.71
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $19.95 / $33.11	Professional	TC	$11.22	$19.95	$33.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $23.99 / $43.65	Facility		$14.45	$23.99	$43.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $29.51 / $48.98	Professional		$14.13	$29.51	$48.98
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $2.63 / $4.47 / $12.59	Professional	26	$2.63	$4.47	$12.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $6.03 / $12.59 / $35.48	Professional	TC	$6.03	$12.59	$35.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $107.15	Facility		$104.71	$104.71	$107.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $30.90 / $51.29	Professional		$19.50	$30.90	$51.29
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $5.25 / $8.91 / $13.80	Professional	26	$5.25	$8.91	$13.80
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $21.88 / $37.15	Professional	TC	$14.45	$21.88	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $15.85 / $51.29	Professional		$9.55	$15.85	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.82 / $4.68 / $13.80	Professional	26	$2.82	$4.68	$13.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $11.22 / $38.90	Professional	TC	$6.76	$11.22	$38.90