Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.80 / $145.05 / $298.25	Facility	26	$126.80	$145.05	$298.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.26 / $475.00 / $1,731.23	Professional		$278.26	$475.00	$1,731.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.04 / $140.00 / $338.00	Professional	26	$71.04	$140.00	$338.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $273.45 / $347.67 / $657.22	Professional	TC	$273.45	$347.67	$657.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.60 / $655.91 / $1,009.04	Professional		$338.60	$655.91	$1,009.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.41 / $115.45 / $187.83	Professional	26	$63.41	$115.45	$187.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $273.49 / $527.78 / $822.30	Professional	TC	$273.49	$527.78	$822.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $604.33 / $697.14 / $835.14	Professional		$604.33	$697.14	$835.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $122.30 / $141.43 / $164.63	Professional	26	$122.30	$141.43	$164.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $478.27 / $555.71 / $670.51	Professional	TC	$478.27	$555.71	$670.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $503.69 / $632.00 / $971.83	Professional		$503.69	$632.00	$971.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.94 / $129.15 / $195.18	Professional	26	$101.94	$129.15	$195.18
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $386.94 / $551.10 / $775.87	Professional	TC	$386.94	$551.10	$775.87
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $94.57 / $126.07 / $129.97	Facility	26	$94.57	$126.07	$129.97
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $160.34 / $178.16 / $302.39	Professional		$160.34	$178.16	$302.39
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $77.18 / $114.84 / $144.00	Professional	26	$77.18	$114.84	$144.00
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $339.29 / $500.26 / $771.98	Professional	TC	$339.29	$500.26	$771.98
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $507.66 / $739.49 / $936.05	Professional		$507.66	$739.49	$936.05
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $66.37 / $115.79 / $187.83	Professional	26	$66.37	$115.79	$187.83
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $273.49 / $526.77 / $822.30	Professional	TC	$273.49	$526.77	$822.30
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 $571.57 / $742.41 / $904.86	Professional		$571.57	$742.41	$904.86
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $114.91 / $136.55 / $181.92	Professional	26	$114.91	$136.55	$181.92
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $456.66 / $598.61 / $744.77	Professional	TC	$456.66	$598.61	$744.77
United Facility/Professional Professional Modifier Low / Median / High Price $304.61 / $465.88 / $1,016.01	Professional		$304.61	$465.88	$1,016.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.34 / $78.31 / $198.14	Professional	26	$58.34	$78.31	$198.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.71 / $362.99 / $820.23	Professional	TC	$245.71	$362.99	$820.23