Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.42 / $33.15 / $53.31	Professional		$23.42	$33.15	$53.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.32 / $23.01 / $29.08	Professional	26	$19.32	$23.01	$29.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $4.09 / $6.17 / $28.32	Professional	TC	$4.09	$6.17	$28.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.83 / $50.25 / $73.75	Professional		$25.83	$50.25	$73.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.12 / $38.27 / $58.24	Professional	26	$22.12	$38.27	$58.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.82 / $9.36 / $15.18	Professional	TC	$3.82	$9.36	$15.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.33 / $53.32 / $60.42	Professional		$25.33	$53.32	$60.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.82 / $44.30 / $49.66	Professional	26	$20.82	$44.30	$49.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $4.50 / $9.02 / $10.73	Professional	TC	$4.50	$9.02	$10.73
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.33 / $42.16 / $64.56	Professional		$30.33	$42.16	$64.56
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.46 / $33.11 / $48.52	Professional	26	$22.46	$33.11	$48.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.72 / $7.37 / $40.50	Professional	TC	$4.72	$7.37	$40.50
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $28.91 / $39.88 / $41.54	Facility	26	$28.91	$39.88	$41.54
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $24.12 / $33.63 / $41.40	Professional	26	$24.12	$33.63	$41.40
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $4.69 / $7.54 / $42.18	Professional	TC	$4.69	$7.54	$42.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.86 / $48.60 / $73.40	Professional		$29.86	$48.60	$73.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.28 / $38.58 / $58.24	Professional	26	$22.28	$38.58	$58.24
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $3.82 / $9.36 / $15.18	Professional	TC	$3.82	$9.36	$15.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $47.49 / $69.34	Professional		$28.98	$47.49	$69.34
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $23.96 / $39.25 / $57.35	Professional	26	$23.96	$39.25	$57.35
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $5.03 / $8.23 / $12.18	Professional	TC	$5.03	$8.23	$12.18
United Facility/Professional Professional Modifier Low / Median / High Price $27.36 / $41.75 / $77.63	Professional		$27.36	$41.75	$77.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.80 / $35.39 / $61.43	Professional	26	$22.80	$35.39	$61.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.68 / $7.44 / $14.08	Professional	TC	$3.68	$7.44	$14.08