Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $48.98 / $54.95	Facility	26	$28.18	$48.98	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $41.69 / $147.91	Professional		$31.62	$41.69	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.18 / $100.00	Professional	26	$20.89	$28.18	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $12.88 / $28.18	Professional	TC	$10.00	$12.88	$28.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $63.10 / $93.33	Professional		$36.31	$63.10	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $39.81 / $57.54	Professional	26	$23.99	$39.81	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $22.39 / $33.88	Professional	TC	$12.59	$22.39	$33.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $79.43 / $93.33	Professional		$61.66	$79.43	$93.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $47.86 / $57.54	Professional	26	$37.15	$47.86	$57.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $30.90 / $36.31	Professional	TC	$23.44	$30.90	$36.31
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $37.15 / $51.29	Facility	26	$34.67	$37.15	$51.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $91.20	Professional		$41.69	$66.07	$91.20
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $42.66 / $64.57	Professional	26	$25.70	$42.66	$64.57
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $26.30 / $35.48	Professional	TC	$15.85	$26.30	$35.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $42.66 / $43.65	Facility	26	$35.48	$42.66	$43.65
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $35.48 / $43.65	Professional	26	$26.30	$35.48	$43.65
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.91 / $24.55	Professional	TC	$15.85	$22.91	$24.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $72.44 / $93.33	Professional		$46.77	$72.44	$93.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $42.66 / $57.54	Professional	26	$25.12	$42.66	$57.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $22.91 / $33.88	Professional	TC	$13.18	$22.91	$33.88
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 $53.70 / $69.18 / $91.20	Professional		$53.70	$69.18	$91.20
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $44.67 / $57.54	Professional	26	$33.88	$44.67	$57.54
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.44 / $31.62	Professional	TC	$19.50	$23.44	$31.62
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $64.57 / $91.20	Professional		$41.69	$64.57	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $43.65 / $63.10	Professional	26	$28.18	$43.65	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $20.89 / $30.90	Professional	TC	$13.80	$20.89	$30.90