Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.54 / $45.70 / $566.22	Facility	26	$34.54	$45.70	$566.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.60 / $61.90 / $127.08	Professional		$39.60	$61.90	$127.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $24.92 / $62.74	Professional	26	$20.89	$24.92	$62.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.23 / $31.19 / $66.39	Professional	TC	$18.23	$31.19	$66.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.72 / $98.18 / $165.21	Professional		$46.72	$98.18	$165.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.25 / $41.49 / $62.76	Professional	26	$25.25	$41.49	$62.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.83 / $57.11 / $106.20	Professional	TC	$20.83	$57.11	$106.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.43 / $124.34 / $149.83	Professional		$101.43	$124.34	$149.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.84 / $43.32 / $51.98	Professional	26	$36.84	$43.32	$51.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $64.59 / $79.18 / $97.83	Professional	TC	$64.59	$79.18	$97.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $55.08 / $85.92 / $144.99	Professional		$55.08	$85.92	$144.99
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.20 / $36.10 / $60.99	Professional	26	$26.20	$36.10	$60.99
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.61 / $61.72 / $110.82	Professional	TC	$45.61	$61.72	$110.82
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $29.55 / $39.81 / $41.48	Facility	26	$29.55	$39.81	$41.48
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $24.12 / $34.81 / $43.56	Professional	26	$24.12	$34.81	$43.56
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $29.58 / $66.95	Professional	TC	$19.30	$29.58	$66.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.22 / $109.85 / $150.66	Professional		$65.22	$109.85	$150.66
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.27 / $39.86 / $55.14	Professional	26	$25.27	$39.86	$55.14
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.83 / $50.74 / $99.56	Professional	TC	$20.83	$50.74	$99.56
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $127.19 / $127.19 / $127.19	Facility	26	$127.19	$127.19	$127.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $112.64 / $149.91	Professional		$66.95	$112.64	$149.91
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $24.40 / $42.43 / $56.10	Professional	26	$24.40	$42.43	$56.10
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $42.11 / $72.65 / $96.30	Professional	TC	$42.11	$72.65	$96.30
United Facility/Professional Professional Modifier Low / Median / High Price $61.60 / $90.34 / $146.44	Professional		$61.60	$90.34	$146.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.54 / $42.59 / $61.43	Professional	26	$30.54	$42.59	$61.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.35 / $51.35 / $94.15	Professional	TC	$28.35	$51.35	$94.15