Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.21 / $13.21 / $61.12	Facility	26	$13.21	$13.21	$61.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $10.48 / $37.53	Professional	26	$9.16	$10.48	$37.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.77 / $18.01 / $61.73	Professional	TC	$14.77	$18.01	$61.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.01 / $49.89 / $75.11	Professional	26	$28.01	$49.89	$75.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.93 / $76.16 / $111.12	Professional	TC	$42.93	$76.16	$111.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.66 / $52.50 / $62.99	Professional	26	$44.66	$52.50	$62.99
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $65.20 / $79.93 / $98.76	Professional	TC	$65.20	$79.93	$98.76
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.58 / $41.32 / $77.25	Professional	26	$32.58	$41.32	$77.25
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.72 / $62.30 / $106.08	Professional	TC	$46.72	$62.30	$106.08
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $32.10 / $48.25 / $48.91	Facility	26	$32.10	$48.25	$48.91
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $29.35 / $37.89 / $48.91	Professional	26	$29.35	$37.89	$48.91
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $58.84 / $70.45 / $72.36	Professional	TC	$58.84	$70.45	$72.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.35 / $48.28 / $66.73	Professional	26	$29.35	$48.28	$66.73
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $44.97 / $75.08 / $101.41	Professional	TC	$44.97	$75.08	$101.41
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $41.25 / $59.90 / $67.16	Professional	26	$41.25	$59.90	$67.16
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $61.02 / $88.61 / $99.36	Professional	TC	$61.02	$88.61	$99.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.46 / $58.40 / $63.64	Professional	26	$27.46	$58.40	$63.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.61 / $86.40 / $94.15	Professional	TC	$40.61	$86.40	$94.15