Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.92 / $228.99 / $469.68	Facility	26	$127.92	$228.99	$469.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.17 / $494.18 / $2,260.39	Professional		$385.17	$494.18	$2,260.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.04 / $154.94 / $533.29	Professional	26	$103.04	$154.94	$533.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $268.99 / $348.53 / $802.96	Professional	TC	$268.99	$348.53	$802.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $375.31 / $750.23 / $1,186.19	Professional		$375.31	$750.23	$1,186.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.59 / $181.89 / $295.48	Professional	26	$100.59	$181.89	$295.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $272.75 / $547.10 / $915.70	Professional	TC	$272.75	$547.10	$915.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $679.66 / $774.38 / $933.54	Professional		$679.66	$774.38	$933.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $194.12 / $223.45 / $261.16	Professional	26	$194.12	$223.45	$261.16
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $479.57 / $552.22 / $672.38	Professional	TC	$479.57	$552.22	$672.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $566.92 / $783.70 / $1,241.59	Professional		$566.92	$783.70	$1,241.59
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $162.24 / $203.53 / $308.04	Professional	26	$162.24	$203.53	$308.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $388.01 / $552.63 / $858.33	Professional	TC	$388.01	$552.63	$858.33
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $149.94 / $200.09 / $205.02	Facility	26	$149.94	$200.09	$205.02
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $132.44 / $182.12 / $223.38	Professional	26	$132.44	$182.12	$223.38
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $396.72 / $582.90 / $921.50	Professional	TC	$396.72	$582.90	$921.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $570.95 / $848.92 / $1,077.11	Professional		$570.95	$848.92	$1,077.11
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $104.16 / $183.24 / $296.00	Professional	26	$104.16	$183.24	$296.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $277.91 / $534.17 / $871.13	Professional	TC	$277.91	$534.17	$871.13
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,538.06 / $1,538.06 / $1,538.06	Facility	26	$1,538.06	$1,538.06	$1,538.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $635.61 / $857.42 / $1,051.06	Professional		$635.61	$857.42	$1,051.06
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $181.35 / $215.08 / $287.08	Professional	26	$181.35	$215.08	$287.08
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $454.26 / $610.45 / $841.19	Professional	TC	$454.26	$610.45	$841.19
United Facility/Professional Professional Modifier Low / Median / High Price $336.21 / $575.96 / $1,134.05	Professional		$336.21	$575.96	$1,134.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.95 / $118.17 / $311.22	Professional	26	$92.95	$118.17	$311.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $243.26 / $458.21 / $839.82	Professional	TC	$243.26	$458.21	$839.82