Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.98 / $5.89 / $6.46	Facility	26	$3.98	$5.89	$6.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $23.44 / $38.90	Professional		$14.13	$23.44	$38.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.00 / $4.07 / $9.55	Professional	26	$2.00	$4.07	$9.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $18.20 / $30.90	Professional	TC	$10.96	$18.20	$30.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $32.36 / $54.95	Professional		$21.38	$32.36	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.89 / $6.17 / $10.96	Professional	26	$3.89	$6.17	$10.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.30 / $43.65	Professional	TC	$17.38	$26.30	$43.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $34.67 / $41.69	Professional		$28.18	$34.67	$41.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $5.50 / $6.61	Professional	26	$4.27	$5.50	$6.61
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $29.51 / $34.67	Professional	TC	$22.39	$29.51	$34.67
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $4.79 / $4.79 / $9.55	Facility	26	$4.79	$4.79	$9.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $34.67 / $47.86	Professional		$22.91	$34.67	$47.86
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.39 / $5.25 / $8.91	Professional	26	$3.39	$5.25	$8.91
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.92 / $36.31	Professional	TC	$17.38	$26.92	$36.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $4.37 / $5.37 / $10.72	Facility	26	$4.37	$5.37	$10.72
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $5.13 / $7.94 / $10.72	Professional	26	$5.13	$7.94	$10.72
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $38.02	Professional	TC	$19.95	$28.84	$38.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $37.15 / $50.12	Professional		$26.92	$37.15	$50.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $4.37 / $7.59 / $11.75	Professional	26	$4.37	$7.59	$11.75
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.90 / $43.65	Professional	TC	$19.50	$30.90	$43.65
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $354.81 / $354.81 / $354.81	Facility	26	$354.81	$354.81	$354.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $34.67 / $48.98	Professional		$25.70	$34.67	$48.98
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $4.47 / $6.46 / $10.72	Professional	26	$4.47	$6.46	$10.72
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $27.54 / $38.90	Professional	TC	$20.89	$27.54	$38.90
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $42.66 / $60.26	Professional		$23.44	$42.66	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $8.91 / $12.59	Professional	26	$5.01	$8.91	$12.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $33.88 / $46.77	Professional	TC	$18.62	$33.88	$46.77