Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.92 / $234.36 / $480.81	Facility	26	$127.92	$234.36	$480.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.86 / $522.50 / $2,507.01	Professional		$370.86	$522.50	$2,507.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.00 / $158.62 / $563.44	Professional	26	$104.00	$158.62	$563.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $264.72 / $368.50 / $825.97	Professional	TC	$264.72	$368.50	$825.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $372.96 / $755.48 / $1,221.17	Professional		$372.96	$755.48	$1,221.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.94 / $187.21 / $302.88	Professional	26	$102.94	$187.21	$302.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $267.98 / $568.54 / $931.63	Professional	TC	$267.98	$568.54	$931.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $675.08 / $773.13 / $926.68	Professional		$675.08	$773.13	$926.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $198.64 / $228.66 / $267.26	Professional	26	$198.64	$228.66	$267.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $470.33 / $545.02 / $659.40	Professional	TC	$470.33	$545.02	$659.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $563.09 / $778.39 / $1,268.48	Professional		$563.09	$778.39	$1,268.48
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $165.99 / $211.05 / $315.14	Professional	26	$165.99	$211.05	$315.14
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $380.54 / $541.98 / $1,388.12	Professional	TC	$380.54	$541.98	$1,388.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $158.27 / $204.76 / $216.41	Facility	26	$158.27	$204.76	$216.41
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $268.35 / $268.35 / $345.93	Professional		$268.35	$268.35	$345.93
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $148.94 / $191.98 / $226.10	Professional	26	$148.94	$191.98	$226.10
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $455.94 / $659.41 / $1,034.15	Professional	TC	$455.94	$659.41	$1,034.15
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $567.61 / $857.60 / $1,088.71	Professional		$567.61	$857.60	$1,088.71
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $106.93 / $191.20 / $302.88	Professional	26	$106.93	$191.20	$302.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $273.51 / $556.66 / $877.45	Professional	TC	$273.51	$556.66	$877.45
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 $632.61 / $852.50 / $1,059.03	Professional		$632.61	$852.50	$1,059.03
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $185.54 / $221.45 / $293.73	Professional	26	$185.54	$221.45	$293.73
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $447.08 / $599.79 / $855.83	Professional	TC	$447.08	$599.79	$855.83
United Facility/Professional Professional Modifier Low / Median / High Price $337.13 / $659.39 / $1,173.28	Professional		$337.13	$659.39	$1,173.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.10 / $123.04 / $319.93	Professional	26	$95.10	$123.04	$319.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.03 / $450.21 / $826.56	Professional	TC	$242.03	$450.21	$826.56