Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $204.17 / $251.19	Facility	26	$85.11	$204.17	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $446.68 / $1,122.02	Professional		$302.00	$446.68	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $123.03 / $302.00	Professional	26	$85.11	$123.03	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $346.74 / $630.96	Professional	TC	$223.87	$346.74	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $549.54 / $1,148.15	Professional		$346.74	$549.54	$1,148.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $134.90 / $281.84	Professional	26	$85.11	$134.90	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $389.05 / $870.96	Professional	TC	$257.04	$389.05	$870.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $741.31 / $933.25	Professional		$660.69	$741.31	$933.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $199.53 / $245.47	Professional	26	$173.78	$199.53	$245.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $549.54 / $691.83	Professional	TC	$478.63	$549.54	$691.83
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $190.55 / $251.19	Facility	26	$85.11	$190.55	$251.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $691.83 / $1,071.52	Professional		$416.87	$691.83	$1,071.52
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $190.55 / $295.12	Professional	26	$97.72	$190.55	$295.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $501.19 / $741.31	Professional	TC	$302.00	$501.19	$741.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $186.21 / $190.55	Facility	26	$154.88	$186.21	$190.55
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $173.78 / $208.93	Professional	26	$120.23	$173.78	$208.93
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $478.63 / $575.44	Professional	TC	$331.13	$478.63	$575.44
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $107.15 / $154.88	Facility	26	$23.44	$107.15	$154.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $758.58 / $1,023.29	Professional		$380.19	$758.58	$1,023.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $194.98 / $281.84	Professional	26	$93.33	$194.98	$281.84
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $524.81 / $812.83	Professional	TC	$263.03	$524.81	$812.83
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $851.14 / $851.14 / $851.14	Facility	26	$851.14	$851.14	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $741.31 / $954.99	Professional		$616.60	$741.31	$954.99
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $199.53 / $257.04	Professional	26	$169.82	$199.53	$257.04
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $549.54 / $724.44	Professional	TC	$457.09	$549.54	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $501.19 / $1,023.29	Professional		$316.23	$501.19	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $128.82 / $281.84	Professional	26	$87.10	$128.82	$281.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $354.81 / $776.25	Professional	TC	$229.09	$354.81	$776.25