Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.00 / $144.32 / $294.86	Facility	26	$104.00	$144.32	$294.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.90 / $475.00 / $1,701.96	Professional		$245.90	$475.00	$1,701.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.76 / $140.00 / $381.49	Professional	26	$65.76	$140.00	$381.49
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $712.50 / $712.50 / $1,252.00	Professional	50	$712.50	$712.50	$1,252.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $198.39 / $335.00 / $616.91	Professional	TC	$198.39	$335.00	$616.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.69 / $537.09 / $811.00	Professional		$247.69	$537.09	$811.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.05 / $115.45 / $185.86	Professional	26	$63.05	$115.45	$185.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.30 / $422.14 / $643.44	Professional	TC	$183.30	$422.14	$643.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $446.66 / $510.03 / $614.12	Professional		$446.66	$510.03	$614.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $121.65 / $140.04 / $163.69	Professional	26	$121.65	$140.04	$163.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $321.26 / $370.03 / $450.40	Professional	TC	$321.26	$370.03	$450.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $372.28 / $522.00 / $839.79	Professional		$372.28	$522.00	$839.79
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.41 / $127.80 / $194.16	Professional	26	$101.41	$127.80	$194.16
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $259.92 / $370.20 / $723.24	Professional	TC	$259.92	$370.20	$723.24
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $94.57 / $125.41 / $129.31	Facility	26	$94.57	$125.41	$129.31
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $160.34 / $160.34 / $160.34	Professional		$160.34	$160.34	$160.34
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $77.18 / $114.84 / $142.08	Professional	26	$77.18	$114.84	$142.08
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $288.64 / $478.61 / $754.00	Professional	TC	$288.64	$478.61	$754.00
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $380.14 / $568.51 / $770.47	Professional		$380.14	$568.51	$770.47
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $65.75 / $115.70 / $185.86	Professional	26	$65.75	$115.70	$185.86
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $186.48 / $421.63 / $643.44	Professional	TC	$186.48	$421.63	$643.44
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 $418.95 / $565.32 / $763.22	Professional		$418.95	$565.32	$763.22
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $114.31 / $135.84 / $180.97	Professional	26	$114.31	$135.84	$180.97
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $304.64 / $410.25 / $620.92	Professional	TC	$304.64	$410.25	$620.92
United Facility/Professional Professional Modifier Low / Median / High Price $222.40 / $399.90 / $777.00	Professional		$222.40	$399.90	$777.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.34 / $75.48 / $197.11	Professional	26	$58.34	$75.48	$197.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.81 / $317.45 / $563.22	Professional	TC	$163.81	$317.45	$563.22