Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.69 / $32.69 / $36.06	Facility	26	$32.69	$32.69	$36.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.23 / $41.27 / $78.58	Professional		$26.23	$41.27	$78.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.74 / $16.77 / $35.10	Professional	26	$13.74	$16.77	$35.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.47 / $20.26 / $56.30	Professional	TC	$12.47	$20.26	$56.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.53 / $80.20 / $132.76	Professional		$34.53	$80.20	$132.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.32 / $29.39 / $44.24	Professional	26	$17.32	$29.39	$44.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.48 / $49.97 / $90.47	Professional	TC	$16.48	$49.97	$90.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.14 / $99.46 / $120.23	Professional		$81.14	$99.46	$120.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.34 / $31.01 / $37.20	Professional	26	$26.34	$31.01	$37.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $54.80 / $67.17 / $83.03	Professional	TC	$54.80	$67.17	$83.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.78 / $66.12 / $116.15	Professional		$39.78	$66.12	$116.15
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.78 / $25.73 / $43.71	Professional	26	$18.78	$25.73	$43.71
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.29 / $52.40 / $95.48	Professional	TC	$39.29	$52.40	$95.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $20.87 / $28.46 / $29.48	Facility	26	$20.87	$28.46	$29.48
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $17.29 / $24.51 / $30.21	Professional	26	$17.29	$24.51	$30.21
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $15.75 / $22.10 / $49.49	Professional	TC	$15.75	$22.10	$49.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.14 / $89.82 / $122.82	Professional		$49.14	$89.82	$122.82
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.68 / $29.07 / $40.36	Professional	26	$17.68	$29.07	$40.36
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.11 / $44.39 / $84.69	Professional	TC	$17.11	$44.39	$84.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $53.31 / $91.98 / $123.68	Professional		$53.31	$91.98	$123.68
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $29.94 / $39.56	Professional	26	$17.39	$29.94	$39.56
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $36.71 / $63.32 / $83.60	Professional	TC	$36.71	$63.32	$83.60
United Facility/Professional Professional Modifier Low / Median / High Price $45.61 / $76.38 / $119.15	Professional		$45.61	$76.38	$119.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $30.81 / $45.06	Professional	26	$20.23	$30.81	$45.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.42 / $47.59 / $98.41	Professional	TC	$21.42	$47.59	$98.41