Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.92 / $229.74 / $469.68	Facility	26	$127.92	$229.74	$469.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.00 / $548.00 / $2,264.53	Professional		$322.00	$548.00	$2,264.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.65 / $154.00 / $535.44	Professional	26	$100.65	$154.00	$535.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.64 / $351.85 / $793.24	Professional	TC	$252.64	$351.85	$793.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.47 / $755.61 / $1,222.85	Professional		$373.47	$755.61	$1,222.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.43 / $182.51 / $296.00	Professional	26	$98.43	$182.51	$296.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $270.92 / $572.36 / $925.98	Professional	TC	$270.92	$572.36	$925.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $675.71 / $772.93 / $927.98	Professional		$675.71	$772.93	$927.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $194.76 / $224.19 / $262.08	Professional	26	$194.76	$224.19	$262.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $474.95 / $550.04 / $665.89	Professional	TC	$474.95	$550.04	$665.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $563.64 / $779.14 / $1,267.20	Professional		$563.64	$779.14	$1,267.20
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $162.79 / $201.00 / $309.06	Professional	26	$162.79	$201.00	$309.06
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $384.27 / $547.29 / $1,279.03	Professional	TC	$384.27	$547.29	$1,279.03
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $148.74 / $200.75 / $205.69	Facility	26	$148.74	$200.75	$205.69
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $268.35 / $268.35 / $298.17	Professional		$268.35	$268.35	$298.17
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $122.21 / $182.70 / $225.75	Professional	26	$122.21	$182.70	$225.75
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $367.68 / $591.66 / $992.07	Professional	TC	$367.68	$591.66	$992.07
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $568.15 / $857.27 / $1,089.74	Professional		$568.15	$857.27	$1,089.74
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $102.55 / $182.51 / $296.00	Professional	26	$102.55	$182.51	$296.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $276.08 / $560.41 / $887.07	Professional	TC	$276.08	$560.41	$887.07
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 $633.21 / $853.32 / $1,057.80	Professional		$633.21	$853.32	$1,057.80
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $181.94 / $215.79 / $288.04	Professional	26	$181.94	$215.79	$288.04
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $451.27 / $606.35 / $863.76	Professional	TC	$451.27	$606.35	$863.76
United Facility/Professional Professional Modifier Low / Median / High Price $336.82 / $640.53 / $1,170.69	Professional		$336.82	$640.53	$1,170.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.95 / $120.24 / $314.95	Professional	26	$92.95	$120.24	$314.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $243.87 / $476.99 / $834.30	Professional	TC	$243.87	$476.99	$834.30