Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.91 / $174.16 / $357.79	Facility	26	$106.91	$174.16	$357.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.24 / $494.18 / $2,051.52	Professional		$328.24	$494.18	$2,051.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.70 / $140.00 / $380.00	Professional	26	$77.70	$140.00	$380.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $267.33 / $347.32 / $680.30	Professional	TC	$267.33	$347.32	$680.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.30 / $88.30 / $88.30	Facility	26	$88.30	$88.30	$88.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $348.67 / $677.93 / $1,044.89	Professional		$348.67	$677.93	$1,044.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.05 / $138.88 / $225.19	Professional	26	$76.05	$138.88	$225.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $270.55 / $535.61 / $819.39	Professional	TC	$270.55	$535.61	$819.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $623.51 / $720.64 / $859.62	Professional		$623.51	$720.64	$859.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $146.66 / $169.96 / $197.45	Professional	26	$146.66	$169.96	$197.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $472.32 / $550.67 / $662.18	Professional	TC	$472.32	$550.67	$662.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $519.64 / $653.86 / $1,002.60	Professional		$519.64	$653.86	$1,002.60
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $122.22 / $158.96 / $233.82	Professional	26	$122.22	$158.96	$233.82
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $382.14 / $544.26 / $858.08	Professional	TC	$382.14	$544.26	$858.08
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $113.68 / $151.19 / $155.44	Facility	26	$113.68	$151.19	$155.44
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $92.86 / $136.88 / $163.30	Professional	26	$92.86	$136.88	$163.30
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $342.35 / $512.12 / $771.98	Professional	TC	$342.35	$512.12	$771.98
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $88.30 / $88.30 / $88.30	Facility	26	$88.30	$88.30	$88.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $527.87 / $777.66 / $972.00	Professional		$527.87	$777.66	$972.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $79.56 / $139.16 / $225.19	Professional	26	$79.56	$139.16	$225.19
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $270.55 / $535.61 / $819.39	Professional	TC	$270.55	$535.61	$819.39
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,298.07 / $2,298.07 / $2,298.07	Facility	26	$2,298.07	$2,298.07	$2,298.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $588.33 / $767.87 / $945.82	Professional		$588.33	$767.87	$945.82
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $137.66 / $164.14 / $217.93	Professional	26	$137.66	$164.14	$217.93
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $450.67 / $591.73 / $749.07	Professional	TC	$450.67	$591.73	$749.07
United Facility/Professional Professional Modifier Low / Median / High Price $315.66 / $535.08 / $1,053.69	Professional		$315.66	$535.08	$1,053.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.86 / $102.56 / $238.28	Professional	26	$70.86	$102.56	$238.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.49 / $373.92 / $822.49	Professional	TC	$244.49	$373.92	$822.49