Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.13 / $122.74 / $342.88	Facility		$66.13	$122.74	$342.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.62 / $54.26 / $93.12	Professional		$26.62	$54.26	$93.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.87 / $9.35 / $20.22	Professional	26	$5.87	$9.35	$20.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $32.81 / $50.50	Professional	TC	$21.32	$32.81	$50.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.05 / $42.05 / $42.05	Facility		$42.05	$42.05	$42.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.18 / $32.99 / $57.68	Professional		$18.18	$32.99	$57.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.44 / $7.66 / $10.90	Professional	26	$3.44	$7.66	$10.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.14 / $25.32 / $46.78	Professional	TC	$14.14	$25.32	$46.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.73 / $65.72 / $93.68	Professional		$31.73	$65.72	$93.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.33 / $13.11 / $18.69	Professional	26	$6.33	$13.11	$18.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.40 / $52.61 / $74.98	Professional	TC	$25.40	$52.61	$74.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $21.27 / $42.84 / $115.22	Facility		$21.27	$42.84	$115.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.70 / $53.94 / $106.11	Professional		$42.70	$53.94	$106.11
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $12.06 / $21.22	Professional	26	$10.68	$12.06	$21.22
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.56 / $60.82 / $84.89	Professional	TC	$38.56	$60.82	$84.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.15 / $61.64 / $72.00	Facility		$42.15	$61.64	$72.00
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $13.10 / $13.60	Facility	26	$9.19	$13.10	$13.60
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $8.03 / $12.66 / $15.96	Professional	26	$8.03	$12.66	$15.96
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $29.35 / $46.51 / $66.86	Professional	TC	$29.35	$46.51	$66.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.56 / $74.70 / $97.00	Facility		$32.56	$74.70	$97.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.99 / $63.24 / $92.77	Professional		$32.99	$63.24	$92.77
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $4.04 / $7.66 / $11.55	Professional	26	$4.04	$7.66	$11.55
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $14.14 / $25.32 / $51.40	Professional	TC	$14.14	$25.32	$51.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $101.09 / $101.09 / $101.66	Facility		$101.09	$101.09	$101.66
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $58.65 / $63.29 / $106.80	Professional		$58.65	$63.29	$106.80
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.97 / $13.63 / $21.36	Professional	26	$11.97	$13.63	$21.36
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $46.68 / $49.68 / $85.44	Professional	TC	$46.68	$49.68	$85.44
United Facility/Professional Professional Modifier Low / Median / High Price $18.84 / $31.40 / $103.29	Professional		$18.84	$31.40	$103.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.30 / $4.33 / $22.14	Professional	26	$4.30	$4.33	$22.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.51 / $24.18 / $86.30	Professional	TC	$14.51	$24.18	$86.30