Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.80 / $5.83 / $9.51	Facility	26	$4.80	$5.83	$9.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.62 / $24.71 / $38.40	Professional		$16.62	$24.71	$38.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.86 / $5.03 / $14.22	Professional	26	$2.86	$5.03	$14.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.40 / $19.69 / $30.80	Professional	TC	$13.40	$19.69	$30.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.49 / $38.09 / $57.87	Professional		$22.49	$38.09	$57.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.45 / $6.89 / $11.74	Professional	26	$4.45	$6.89	$11.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $30.92 / $46.02	Professional	TC	$17.73	$30.92	$46.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.43 / $32.03 / $40.61	Professional		$28.43	$32.03	$40.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $4.72 / $5.49 / $6.53	Professional	26	$4.72	$5.49	$6.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.41 / $26.50 / $31.80	Professional	TC	$22.41	$26.50	$31.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $21.60 / $35.74 / $47.76	Professional		$21.60	$35.74	$47.76
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.76 / $5.18 / $9.44	Professional	26	$3.76	$5.18	$9.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.16 / $23.94 / $36.97	Professional	TC	$16.16	$23.94	$36.97
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $4.38 / $5.36 / $10.72	Facility	26	$4.38	$5.36	$10.72
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $5.36 / $7.75 / $10.72	Professional	26	$5.36	$7.75	$10.72
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $20.88 / $27.54 / $38.19	Professional	TC	$20.88	$27.54	$38.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.17 / $36.09 / $51.10	Professional		$27.17	$36.09	$51.10
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $4.48 / $7.08 / $11.93	Professional	26	$4.48	$7.08	$11.93
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.19 / $32.47 / $46.18	Professional	TC	$19.19	$32.47	$46.18
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $354.01 / $354.01 / $354.01	Facility	26	$354.01	$354.01	$354.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $19.13 / $34.97 / $50.70	Professional		$19.13	$34.97	$50.70
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $3.64 / $6.48 / $10.40	Professional	26	$3.64	$6.48	$10.40
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $15.73 / $28.50 / $39.56	Professional	TC	$15.73	$28.50	$39.56
United Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $42.85 / $58.97	Professional		$28.98	$42.85	$58.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.37 / $8.88 / $12.09	Professional	26	$6.37	$8.88	$12.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.66 / $33.92 / $46.52	Professional	TC	$22.66	$33.92	$46.52