Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.57 / $46.66 / $77.17	Professional		$29.57	$46.66	$77.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.84 / $17.38 / $25.18	Professional	26	$13.84	$17.38	$25.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.74 / $25.58 / $40.58	Professional	TC	$15.74	$25.58	$40.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.34 / $66.00 / $95.75	Professional		$34.34	$66.00	$95.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $29.98 / $44.62	Professional	26	$16.39	$29.98	$44.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.95 / $37.25 / $52.12	Professional	TC	$17.95	$37.25	$52.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $71.02 / $82.39	Professional		$34.54	$71.02	$82.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.76 / $33.51 / $37.59	Professional	26	$15.76	$33.51	$37.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.78 / $37.49 / $44.80	Professional	TC	$18.78	$37.49	$44.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $27.05 / $43.73 / $94.02	Facility		$27.05	$43.73	$94.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $56.61 / $85.47	Professional		$36.22	$56.61	$85.47
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.02 / $26.60 / $40.46	Professional	26	$17.02	$26.60	$40.46
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.20 / $30.00 / $48.00	Professional	TC	$19.20	$30.00	$48.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.55 / $64.31 / $87.12	Facility		$46.55	$64.31	$87.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $22.29 / $30.82 / $32.54	Facility	26	$22.29	$30.82	$32.54
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $21.35 / $25.85 / $34.84	Professional	26	$21.35	$25.85	$34.84
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $22.36 / $30.50 / $53.58	Professional	TC	$22.36	$30.50	$53.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $31.70 / $45.67 / $94.02	Facility		$31.70	$45.67	$94.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.24 / $64.15 / $91.25	Professional		$42.24	$64.15	$91.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.32 / $30.44 / $44.62	Professional	26	$17.32	$30.44	$44.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $37.90 / $52.12	Professional	TC	$19.32	$37.90	$52.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.25 / $62.68 / $91.58	Professional		$38.25	$62.68	$91.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $29.76 / $43.47	Professional	26	$18.14	$29.76	$43.47
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $20.09 / $32.93 / $48.10	Professional	TC	$20.09	$32.93	$48.10
United Facility/Professional Professional Modifier Low / Median / High Price $38.96 / $55.67 / $94.51	Professional		$38.96	$55.67	$94.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.48 / $27.10 / $45.26	Professional	26	$17.48	$27.10	$45.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $28.99 / $50.66	Professional	TC	$19.12	$28.99	$50.66