Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $10.72 / $61.66	Facility	26	$7.08	$10.72	$61.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $12.02 / $125.89	Professional	26	$5.01	$12.02	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.91 / $154.88	Professional	TC	$18.20	$22.91	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $46.77 / $72.44	Professional	26	$27.54	$46.77	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $158.49 / $234.42	Professional	TC	$91.20	$158.49	$234.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $52.48 / $63.10	Professional	26	$41.69	$52.48	$63.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $169.82 / $213.80	Professional	TC	$144.54	$169.82	$213.80
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $10.72 / $10.72	Facility	26	$7.76	$10.72	$10.72
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $44.67 / $64.57	Professional	26	$13.80	$44.67	$64.57
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $134.90 / $194.98	Professional	TC	$44.67	$134.90	$194.98
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $47.86 / $48.98	Facility	26	$39.81	$47.86	$48.98
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $39.81 / $47.86	Professional	26	$28.84	$39.81	$47.86
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $151.36 / $154.88	Professional	TC	$125.89	$151.36	$154.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $47.86 / $67.61	Professional	26	$27.54	$47.86	$67.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $158.49 / $218.78	Professional	TC	$91.20	$158.49	$218.78
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $50.12 / $64.57	Professional	26	$33.88	$50.12	$64.57
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $158.49 / $208.93	Professional	TC	$93.33	$158.49	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $44.67 / $66.07	Professional	26	$30.20	$44.67	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $141.25 / $208.93	Professional	TC	$97.72	$141.25	$208.93