Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.81 / $15.87 / $20.83	Facility	26	$12.81	$15.87	$20.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $43.12 / $169.15	Professional		$28.91	$43.12	$169.15
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $37.15 / $37.15 / $47.07	Professional	25	$37.15	$37.15	$47.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $10.98 / $35.15	Professional	26	$7.95	$10.98	$35.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.81 / $29.06 / $53.21	Professional	TC	$20.81	$29.06	$53.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.84 / $61.92 / $82.28	Professional		$33.84	$61.92	$82.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $15.68 / $21.78	Professional	26	$9.10	$15.68	$21.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.48 / $45.19 / $63.13	Professional	TC	$26.48	$45.19	$63.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.27 / $58.35 / $73.97	Professional		$52.27	$58.35	$73.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.61 / $17.01 / $20.23	Professional	26	$14.61	$17.01	$20.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.25 / $41.69 / $50.03	Professional	TC	$35.25	$41.69	$50.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.25 / $56.96 / $74.42	Professional		$39.25	$56.96	$74.42
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.25 / $14.90 / $24.39	Professional	26	$11.25	$14.90	$24.39
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.33 / $37.51 / $56.94	Professional	TC	$25.33	$37.51	$56.94
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $11.63 / $15.78 / $16.18	Facility	26	$11.63	$15.78	$16.18
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $14.16 / $16.50	Professional	26	$9.65	$14.16	$16.50
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $30.80 / $42.16 / $52.26	Professional	TC	$30.80	$42.16	$52.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.97 / $62.88 / $80.41	Professional		$43.97	$62.88	$80.41
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $16.28 / $21.78	Professional	26	$9.36	$16.28	$21.78
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.83 / $47.06 / $63.13	Professional	TC	$27.83	$47.06	$63.13
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $459.43 / $459.43 / $459.43	Facility	26	$459.43	$459.43	$459.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.50 / $60.75 / $83.72	Professional		$36.50	$60.75	$83.72
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $17.07 / $22.74	Professional	26	$10.19	$17.07	$22.74
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $24.65 / $43.98 / $59.68	Professional	TC	$24.65	$43.98	$59.68
United Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $68.69 / $93.59	Professional		$46.00	$68.69	$93.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.52 / $16.80 / $25.52	Professional	26	$11.52	$16.80	$25.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.96 / $50.92 / $68.64	Professional	TC	$34.96	$50.92	$68.64