Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.92 / $235.17 / $502.47	Facility	26	$127.92	$235.17	$502.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.93 / $497.42 / $1,320.50	Professional		$349.93	$497.42	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.00 / $165.71 / $536.75	Professional	26	$104.00	$165.71	$536.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.38 / $348.53 / $730.50	Professional	TC	$249.38	$348.53	$730.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.72 / $708.22 / $1,154.91	Professional		$352.72	$708.22	$1,154.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.54 / $195.07 / $316.64	Professional	26	$107.54	$195.07	$316.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $243.01 / $487.77 / $868.54	Professional	TC	$243.01	$487.77	$868.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $640.60 / $727.76 / $877.48	Professional		$640.60	$727.76	$877.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $207.48 / $238.84 / $279.20	Professional	26	$207.48	$238.84	$279.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $426.73 / $490.22 / $598.28	Professional	TC	$426.73	$490.22	$598.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $550.22 / $738.86 / $1,235.98	Professional		$550.22	$738.86	$1,235.98
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $173.46 / $217.73 / $329.37	Professional	26	$173.46	$217.73	$329.37
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $345.31 / $491.81 / $1,218.73	Professional	TC	$345.31	$491.81	$1,218.73
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $160.22 / $213.86 / $219.76	Facility	26	$160.22	$213.86	$219.76
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $268.35 / $268.35 / $268.35	Professional		$268.35	$268.35	$268.35
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $131.86 / $196.80 / $231.24	Professional	26	$131.86	$196.80	$231.24
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $313.16 / $479.70 / $1,038.40	Professional	TC	$313.16	$479.70	$1,038.40
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $538.13 / $783.08 / $1,009.63	Professional		$538.13	$783.08	$1,009.63
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $111.43 / $199.06 / $316.64	Professional	26	$111.43	$199.06	$316.64
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $243.01 / $476.27 / $795.70	Professional	TC	$243.01	$476.27	$795.70
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 $597.90 / $782.95 / $1,012.29	Professional		$597.90	$782.95	$1,012.29
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $193.91 / $229.94 / $306.99	Professional	26	$193.91	$229.94	$306.99
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $403.99 / $529.97 / $761.67	Professional	TC	$403.99	$529.97	$761.67
United Facility/Professional Professional Modifier Low / Median / High Price $316.89 / $537.16 / $1,067.72	Professional		$316.89	$537.16	$1,067.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.70 / $139.19 / $335.40	Professional	26	$99.70	$139.19	$335.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.19 / $368.17 / $731.80	Professional	TC	$217.19	$368.17	$731.80