Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.95 / $142.66 / $352.43	Facility		$90.95	$142.66	$352.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.32 / $81.54 / $90.09	Facility	26	$51.32	$81.54	$90.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.82 / $107.04 / $357.86	Professional		$37.82	$107.04	$357.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $77.98 / $116.97	Professional	26	$34.40	$77.98	$116.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.80 / $67.34 / $163.52	Professional	TC	$27.80	$67.34	$163.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.95 / $71.95 / $71.95	Facility		$71.95	$71.95	$71.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.98 / $41.98 / $41.98	Facility	26	$41.98	$41.98	$41.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.53 / $151.44 / $266.64	Professional		$101.53	$151.44	$266.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.83 / $83.70 / $130.90	Professional	26	$55.83	$83.70	$130.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.95 / $66.86 / $161.52	Professional	TC	$43.95	$66.86	$161.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.01 / $148.65 / $169.74	Professional		$114.01	$148.65	$169.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.83 / $82.78 / $93.21	Professional	26	$63.83	$82.78	$93.21
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.18 / $65.19 / $76.54	Professional	TC	$50.18	$65.19	$76.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $65.38 / $142.36 / $439.48	Facility		$65.38	$142.36	$439.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.48 / $139.75 / $358.47	Professional		$102.48	$139.75	$358.47
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.18 / $82.86 / $137.60	Professional	26	$58.18	$82.86	$137.60
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.28 / $58.32 / $201.84	Professional	TC	$40.28	$58.32	$201.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.45 / $128.63 / $359.12	Facility		$95.45	$128.63	$359.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $59.88 / $72.36 / $142.35	Facility	26	$59.88	$72.36	$142.35
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $45.41 / $47.37	Professional		$45.41	$45.41	$47.37
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $50.65 / $81.75 / $139.86	Professional	26	$50.65	$81.75	$139.86
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $41.21 / $65.42 / $216.92	Professional	TC	$41.21	$65.42	$216.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.34 / $163.90 / $439.48	Facility		$66.34	$163.90	$439.48
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $41.98 / $41.98 / $41.98	Facility	26	$41.98	$41.98	$41.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.77 / $149.84 / $269.25	Professional		$89.77	$149.84	$269.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $54.34 / $83.16 / $127.35	Professional	26	$54.34	$83.16	$127.35
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $44.17 / $66.86 / $161.52	Professional	TC	$44.17	$66.86	$161.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $389.95 / $496.95 / $618.64	Facility		$389.95	$496.95	$618.64
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 $117.47 / $138.62 / $203.57	Professional		$117.47	$138.62	$203.57
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $67.04 / $79.06 / $116.17	Professional	26	$67.04	$79.06	$116.17
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $50.44 / $59.10 / $88.12	Professional	TC	$50.44	$59.10	$88.12
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $4,362.00 / $6,216.00	Facility		$376.00	$4,362.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $103.68 / $161.63 / $342.72	Professional		$103.68	$161.63	$342.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.41 / $91.28 / $139.22	Professional	26	$59.41	$91.28	$139.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.27 / $70.79 / $221.90	Professional	TC	$44.27	$70.79	$221.90