Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $426.58 / $7,943.28	Facility		$338.84	$426.58	$7,943.28
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $87.10 / $97.72	Facility	26	$51.29	$87.10	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $229.09 / $588.84	Professional		$151.36	$229.09	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $51.29 / $125.89	Professional	26	$38.90	$51.29	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $158.49 / $398.11	Professional	TC	$93.33	$158.49	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $407.38 / $562.34	Professional		$190.55	$407.38	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $89.13 / $128.82	Professional	26	$44.67	$89.13	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $316.23 / $446.68	Professional	TC	$151.36	$316.23	$446.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $331.13 / $436.52	Professional		$251.19	$331.13	$436.52
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $83.18 / $100.00	Professional	26	$63.10	$83.18	$100.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $251.19 / $331.13	Professional	TC	$190.55	$251.19	$331.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $275.42 / $562.34	Facility		$199.53	$275.42	$562.34
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $263.03 / $501.19	Professional		$169.82	$263.03	$501.19
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $81.28 / $128.82	Professional	26	$50.12	$81.28	$128.82
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $245.47 / $407.38	Professional	TC	$147.91	$245.47	$407.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $275.42 / $380.19	Facility		$181.97	$275.42	$380.19
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $75.86 / $79.43	Facility	26	$64.57	$75.86	$79.43
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $83.18	Professional	26	$52.48	$69.18	$83.18
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $134.90 / $269.15	Professional	TC	$95.50	$134.90	$269.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $263.03 / $436.52	Facility		$173.78	$263.03	$436.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $380.19 / $524.81	Professional		$204.17	$380.19	$524.81
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $81.28 / $114.82	Professional	26	$54.95	$81.28	$114.82
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $245.47 / $416.87	Professional	TC	$131.83	$245.47	$416.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $407.38 / $537.03	Professional		$354.81	$407.38	$537.03
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $85.11 / $107.15	Professional	26	$72.44	$85.11	$107.15
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $331.13 / $436.52	Professional	TC	$281.84	$331.13	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $4,073.80 / $6,165.95	Facility		$389.05	$4,073.80	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $295.12 / $501.19	Professional		$208.93	$295.12	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $79.43 / $112.20	Professional	26	$58.88	$79.43	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $213.80 / $398.11	Professional	TC	$131.83	$213.80	$398.11