Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $33.88 / $36.31	Facility	26	$19.05	$33.88	$36.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $45.71 / $97.72	Professional		$26.30	$45.71	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.85 / $33.11	Professional	26	$12.88	$15.85	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $28.84 / $58.88	Professional	TC	$12.02	$28.84	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $81.28 / $131.83	Professional		$33.88	$81.28	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $27.54 / $42.66	Professional	26	$15.85	$27.54	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $56.23 / $91.20	Professional	TC	$15.49	$56.23	$91.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $120.23	Professional		$79.43	$95.50	$120.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.90 / $37.15	Professional	26	$24.55	$30.90	$37.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $64.57 / $83.18	Professional	TC	$54.95	$64.57	$83.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $67.61 / $109.65	Professional		$42.66	$67.61	$109.65
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $26.92 / $37.15	Professional	26	$16.98	$26.92	$37.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $56.23 / $79.43	Professional	TC	$35.48	$56.23	$79.43
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $28.18 / $29.51	Facility	26	$23.44	$28.18	$29.51
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $25.12 / $30.20	Professional	26	$17.38	$25.12	$30.20
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $21.88 / $57.54	Professional	TC	$14.13	$21.88	$57.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $89.13 / $123.03	Professional		$42.66	$89.13	$123.03
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $27.54 / $38.02	Professional	26	$17.78	$27.54	$38.02
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $40.74 / $83.18	Professional	TC	$16.60	$40.74	$83.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $91.20 / $120.23	Professional		$53.70	$91.20	$120.23
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $29.51 / $38.02	Professional	26	$18.20	$29.51	$38.02
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $63.10 / $81.28	Professional	TC	$28.84	$63.10	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $75.86 / $117.49	Professional		$40.74	$75.86	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $30.90 / $42.66	Professional	26	$18.62	$30.90	$42.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $46.77 / $77.62	Professional	TC	$20.42	$46.77	$77.62