Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.75 / $10.79 / $61.12	Facility	26	$7.75	$10.79	$61.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $7.33 / $131.00	Professional	26	$5.82	$7.33	$131.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $23.21 / $132.18	Professional	TC	$20.14	$23.21	$132.18
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 $92.23 / $163.63 / $238.70	Professional	TC	$92.23	$163.63	$238.70
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 $139.56 / $171.07 / $211.41	Professional	TC	$139.56	$171.07	$211.41
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.58 / $42.50 / $71.70	Professional	26	$32.58	$42.50	$71.70
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $82.96 / $129.62 / $227.91	Professional	TC	$82.96	$129.62	$227.91
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 $28.95 / $40.13 / $48.91	Professional	26	$28.95	$40.13	$48.91
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $125.93 / $150.82 / $155.44	Professional	TC	$125.93	$150.82	$155.44
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 $96.62 / $161.32 / $217.90	Professional	TC	$96.62	$161.32	$217.90
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 $131.08 / $190.36 / $213.44	Professional	TC	$131.08	$190.36	$213.44
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 $101.17 / $194.31 / $202.27	Professional	TC	$101.17	$194.31	$202.27