Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.50 / $23.47 / $54.83	Facility	26	$17.50	$23.47	$54.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.75 / $42.06 / $172.30	Professional		$31.75	$42.06	$172.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.34 / $15.58 / $62.00	Professional	26	$10.34	$15.58	$62.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.35 / $23.76 / $50.77	Professional	TC	$19.35	$23.76	$50.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.90 / $11.90 / $11.90	Facility	26	$11.90	$11.90	$11.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $70.00 / $90.47	Professional		$40.54	$70.00	$90.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.50 / $24.06 / $32.79	Professional	26	$15.50	$24.06	$32.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.16 / $45.81 / $59.99	Professional	TC	$26.16	$45.81	$59.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.86 / $71.06 / $82.02	Professional		$59.86	$71.06	$82.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $23.77 / $26.77	Professional	26	$19.82	$23.77	$26.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.42 / $47.07 / $55.22	Professional	TC	$39.42	$47.07	$55.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.58 / $65.09 / $92.52	Professional		$48.58	$65.09	$92.52
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.55 / $22.00 / $32.90	Professional	26	$16.55	$22.00	$32.90
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.03 / $42.58 / $61.65	Professional	TC	$32.03	$42.58	$61.65
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $17.04 / $20.45 / $26.13	Facility	26	$17.04	$20.45	$26.13
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $19.60 / $26.13	Professional	26	$13.58	$19.60	$26.13
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $39.40 / $46.90	Professional	TC	$28.14	$39.40	$46.90
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.90 / $11.90 / $11.90	Facility	26	$11.90	$11.90	$11.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $55.06 / $71.80 / $92.69	Professional		$55.06	$71.80	$92.69
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.84 / $24.57 / $34.76	Professional	26	$15.84	$24.57	$34.76
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.18 / $46.74 / $67.18	Professional	TC	$27.18	$46.74	$67.18
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $459.43 / $459.43 / $459.43	Facility	26	$459.43	$459.43	$459.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.56 / $67.38 / $89.51	Professional		$57.56	$67.38	$89.51
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $19.61 / $24.43 / $32.52	Professional	26	$19.61	$24.43	$32.52
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $34.34 / $44.42 / $58.09	Professional	TC	$34.34	$44.42	$58.09
United Facility/Professional Professional Modifier Low / Median / High Price $37.89 / $73.48 / $101.02	Professional		$37.89	$73.48	$101.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.44 / $26.79 / $36.07	Professional	26	$14.44	$26.79	$36.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.45 / $42.88 / $66.08	Professional	TC	$23.45	$42.88	$66.08