Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $149.60 / $170.98 / $345.46	Facility	26	$149.60	$170.98	$345.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $315.05 / $477.88 / $1,390.00	Professional		$315.05	$477.88	$1,390.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.72 / $140.00 / $381.44	Professional	26	$70.72	$140.00	$381.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $224.02 / $348.53 / $631.87	Professional	TC	$224.02	$348.53	$631.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $377.06 / $727.29 / $1,104.47	Professional		$377.06	$727.29	$1,104.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.31 / $124.51 / $201.59	Professional	26	$68.31	$124.51	$201.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $307.27 / $602.78 / $940.89	Professional	TC	$307.27	$602.78	$940.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $672.25 / $777.98 / $929.38	Professional		$672.25	$777.98	$929.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $131.80 / $151.72 / $177.35	Professional	26	$131.80	$151.72	$177.35
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $536.39 / $626.34 / $752.03	Professional	TC	$536.39	$626.34	$752.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $560.34 / $713.50 / $1,081.11	Professional		$560.34	$713.50	$1,081.11
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $109.94 / $140.59 / $210.45	Professional	26	$109.94	$140.59	$210.45
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $433.92 / $618.00 / $875.22	Professional	TC	$433.92	$618.00	$875.22
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $101.92 / $135.85 / $139.36	Facility	26	$101.92	$135.85	$139.36
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $302.39 / $302.39	Professional		$302.39	$302.39	$302.39
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $82.81 / $121.41 / $149.04	Professional	26	$82.81	$121.41	$149.04
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $387.53 / $562.08 / $819.68	Professional	TC	$387.53	$562.08	$819.68
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $564.72 / $829.19 / $1,049.04	Professional		$564.72	$829.19	$1,049.04
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $71.29 / $124.51 / $201.59	Professional	26	$71.29	$124.51	$201.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $307.27 / $602.78 / $940.89	Professional	TC	$307.27	$602.78	$940.89
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $782.93 / $782.93 / $782.93	Facility	26	$782.93	$782.93	$782.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $636.21 / $833.96 / $1,007.19	Professional		$636.21	$833.96	$1,007.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $123.89 / $146.44 / $196.13	Professional	26	$123.89	$146.44	$196.13
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $512.32 / $672.30 / $837.02	Professional	TC	$512.32	$672.30	$837.02
United Facility/Professional Professional Modifier Low / Median / High Price $342.35 / $479.81 / $1,151.61	Professional		$342.35	$479.81	$1,151.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.22 / $90.66 / $215.00	Professional	26	$63.22	$90.66	$215.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $278.54 / $544.79 / $950.14	Professional	TC	$278.54	$544.79	$950.14