Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $234.42 / $407.38	Facility	26	$104.71	$234.42	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $501.19 / $1,202.26	Professional		$354.81	$501.19	$1,202.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $190.55 / $512.86	Professional	26	$107.15	$190.55	$512.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $338.84 / $724.44	Professional	TC	$239.88	$338.84	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $676.08 / $1,479.11	Professional		$338.84	$676.08	$1,479.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $162.18 / $323.59	Professional	26	$102.33	$162.18	$323.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $478.63 / $1,258.93	Professional	TC	$229.09	$478.63	$1,258.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $707.95 / $870.96	Professional		$616.60	$707.95	$870.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $229.09 / $281.84	Professional	26	$199.53	$229.09	$281.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $478.63 / $602.56	Professional	TC	$407.38	$478.63	$602.56
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $194.98 / $407.38	Facility	26	$104.71	$194.98	$407.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $724.44 / $1,348.96	Professional		$478.63	$724.44	$1,348.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $218.78 / $338.84	Professional	26	$134.90	$218.78	$338.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $489.78 / $1,230.27	Professional	TC	$338.84	$489.78	$1,230.27
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $213.80 / $218.78	Facility	26	$177.83	$213.80	$218.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Professional		$436.52	$436.52	$436.52
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $199.53 / $234.42	Professional	26	$131.83	$199.53	$234.42
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $478.63 / $1,047.13	Professional	TC	$316.23	$478.63	$1,047.13
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $123.03 / $177.83	Facility	26	$26.92	$123.03	$177.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $758.58 / $1,202.26	Professional		$363.08	$758.58	$1,202.26
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $223.87 / $323.59	Professional	26	$107.15	$223.87	$323.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $549.54 / $1,174.90	Professional	TC	$229.09	$549.54	$1,174.90
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Facility	26	$1,548.82	$1,548.82	$1,548.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $741.31 / $1,000.00	Professional		$602.56	$741.31	$1,000.00
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $229.09 / $295.12	Professional	26	$194.98	$229.09	$295.12
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $512.86 / $676.08	Professional	TC	$407.38	$512.86	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $676.08 / $1,122.02	Professional		$316.23	$676.08	$1,122.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $138.04 / $316.23	Professional	26	$100.00	$138.04	$316.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $467.74 / $776.25	Professional	TC	$218.78	$467.74	$776.25