Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $177.83 / $295.12	Facility	26	$125.89	$177.83	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $524.81 / $1,584.89	Professional		$331.13	$524.81	$1,584.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $141.25 / $346.74	Professional	26	$77.62	$141.25	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $354.81 / $676.08	Professional	TC	$257.04	$354.81	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $616.60 / $1,148.15	Professional		$331.13	$616.60	$1,148.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $109.65 / $234.42	Professional	26	$72.44	$109.65	$234.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $501.19 / $954.99	Professional	TC	$257.04	$501.19	$954.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $707.95 / $870.96	Professional		$602.56	$707.95	$870.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $162.18 / $199.53	Professional	26	$141.25	$162.18	$199.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $537.03 / $660.69	Professional	TC	$467.74	$537.03	$660.69
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $177.83 / $295.12	Facility	26	$104.71	$177.83	$295.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $691.83 / $1,071.52	Professional		$512.86	$691.83	$1,071.52
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $154.88 / $234.42	Professional	26	$123.03	$154.88	$234.42
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $549.54 / $870.96	Professional	TC	$363.08	$549.54	$870.96
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $151.36 / $154.88	Facility	26	$125.89	$151.36	$154.88
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $457.09	Professional		$426.58	$426.58	$457.09
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $141.25 / $173.78	Professional	26	$93.33	$141.25	$173.78
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $512.86 / $794.33	Professional	TC	$338.84	$512.86	$794.33
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $125.89	Facility	26	$18.62	$87.10	$125.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $741.31 / $1,023.29	Professional		$354.81	$741.31	$1,023.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $158.49 / $229.09	Professional	26	$75.86	$158.49	$229.09
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $602.56 / $891.25	Professional	TC	$257.04	$602.56	$891.25
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Facility	26	$2,290.87	$2,290.87	$2,290.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $741.31 / $954.99	Professional		$588.84	$741.31	$954.99
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $165.96 / $208.93	Professional	26	$138.04	$165.96	$208.93
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $575.44 / $758.58	Professional	TC	$446.68	$575.44	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $562.34 / $1,047.13	Professional		$316.23	$562.34	$1,047.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $97.72 / $234.42	Professional	26	$70.79	$97.72	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $457.09 / $831.76	Professional	TC	$245.47	$457.09	$831.76