Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.45 / $82.55 / $85.54	Facility	26	$11.45	$82.55	$85.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.83 / $39.40 / $139.19	Professional		$27.83	$39.40	$139.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $10.61 / $38.60	Professional	26	$7.20	$10.61	$38.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.04 / $24.11 / $49.86	Professional	TC	$20.04	$24.11	$49.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.24 / $56.59 / $83.27	Professional		$33.24	$56.59	$83.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.34 / $14.96 / $21.61	Professional	26	$9.34	$14.96	$21.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.45 / $42.31 / $61.26	Professional	TC	$25.45	$42.31	$61.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.34 / $55.17 / $67.06	Professional		$47.34	$55.17	$67.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.16 / $15.57 / $17.97	Professional	26	$13.16	$15.57	$17.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.96 / $39.75 / $49.10	Professional	TC	$33.96	$39.75	$49.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.50 / $47.12 / $76.26	Professional		$39.50	$47.12	$76.26
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.20 / $14.80 / $22.27	Professional	26	$11.20	$14.80	$22.27
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.28 / $39.03 / $56.22	Professional	TC	$28.28	$39.03	$56.22
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $10.17 / $13.78 / $14.95	Facility	26	$10.17	$13.78	$14.95
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $11.97 / $15.41	Professional	26	$8.44	$11.97	$15.41
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $24.52 / $32.34 / $43.04	Professional	TC	$24.52	$32.34	$43.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.52 / $57.83 / $73.45	Professional		$44.52	$57.83	$73.45
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $15.46 / $20.32	Professional	26	$9.51	$15.46	$20.32
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $26.45 / $41.64 / $53.90	Professional	TC	$26.45	$41.64	$53.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.49 / $58.54 / $71.93	Professional		$47.49	$58.54	$71.93
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.28 / $16.39 / $19.89	Professional	26	$13.28	$16.39	$19.89
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $34.19 / $42.90 / $52.10	Professional	TC	$34.19	$42.90	$52.10
United Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $52.51 / $77.53	Professional		$31.17	$52.51	$77.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.33 / $14.71 / $22.36	Professional	26	$8.33	$14.71	$22.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.80 / $37.79 / $55.94	Professional	TC	$21.80	$37.79	$55.94