Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.87 / $36.10 / $43.68	Facility	26	$23.87	$36.10	$43.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $54.70 / $123.98	Professional		$37.79	$54.70	$123.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.35 / $23.78 / $44.01	Professional	26	$18.35	$23.78	$44.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.44 / $27.91 / $57.56	Professional	TC	$16.44	$27.91	$57.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.57 / $89.99 / $143.57	Professional		$41.57	$89.99	$143.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.86 / $35.68 / $55.54	Professional	26	$22.86	$35.68	$55.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.05 / $50.48 / $92.44	Professional	TC	$18.05	$50.48	$92.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.92 / $107.77 / $129.88	Professional		$87.92	$107.77	$129.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.89 / $37.52 / $45.02	Professional	26	$31.89	$37.52	$45.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $56.03 / $68.68 / $84.87	Professional	TC	$56.03	$68.68	$84.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.04 / $69.94 / $123.70	Professional		$53.04	$69.94	$123.70
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $31.29 / $53.88	Professional	26	$22.71	$31.29	$53.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.18 / $55.35 / $97.59	Professional	TC	$40.18	$55.35	$97.59
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $28.59 / $34.47 / $41.54	Facility	26	$28.59	$34.47	$41.54
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $24.39 / $33.61 / $43.55	Professional	26	$24.39	$33.61	$43.55
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $19.00 / $26.68 / $60.55	Professional	TC	$19.00	$26.68	$60.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.24 / $96.69 / $132.61	Professional		$57.24	$96.69	$132.61
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.25 / $35.19 / $50.34	Professional	26	$22.25	$35.19	$50.34
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.05 / $44.85 / $86.54	Professional	TC	$18.05	$44.85	$86.54
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	26	$58.88	$58.88	$58.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $99.31 / $132.12	Professional		$57.66	$99.31	$132.12
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $21.09 / $36.79 / $49.77	Professional	26	$21.09	$36.79	$49.77
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $37.09 / $63.98 / $84.48	Professional	TC	$37.09	$63.98	$84.48
United Facility/Professional Professional Modifier Low / Median / High Price $56.66 / $81.73 / $128.66	Professional		$56.66	$81.73	$128.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.03 / $40.45 / $54.79	Professional	26	$27.03	$40.45	$54.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.25 / $46.23 / $82.89	Professional	TC	$26.25	$46.23	$82.89