Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $177.44 / $201.99 / $408.03	Facility	26	$177.44	$201.99	$408.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.56 / $494.18 / $909.36	Professional		$317.56	$494.18	$909.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.18 / $128.00 / $201.99	Professional	26	$82.18	$128.00	$201.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $235.38 / $348.53 / $636.90	Professional	TC	$235.38	$348.53	$636.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.72 / $674.88 / $1,037.38	Professional		$335.72	$674.88	$1,037.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.59 / $147.79 / $237.98	Professional	26	$80.59	$147.79	$237.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.29 / $521.78 / $826.05	Professional	TC	$253.29	$521.78	$826.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $606.21 / $692.29 / $834.36	Professional		$606.21	$692.29	$834.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $155.53 / $179.75 / $209.23	Professional	26	$155.53	$179.75	$209.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $445.89 / $512.53 / $625.13	Professional	TC	$445.89	$512.53	$625.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $505.34 / $698.56 / $1,019.97	Professional		$505.34	$698.56	$1,019.97
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $129.69 / $163.63 / $249.06	Professional	26	$129.69	$163.63	$249.06
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $360.79 / $513.85 / $870.03	Professional	TC	$360.79	$513.85	$870.03
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $121.03 / $160.31 / $166.16	Facility	26	$121.03	$160.31	$166.16
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $268.35 / $268.35 / $457.29	Professional		$268.35	$268.35	$457.29
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $102.99 / $147.00 / $174.84	Professional	26	$102.99	$147.00	$174.84
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $371.76 / $574.03 / $940.80	Professional	TC	$371.76	$574.03	$940.80
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $516.01 / $768.47 / $978.50	Professional		$516.01	$768.47	$978.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $84.44 / $147.79 / $237.98	Professional	26	$84.44	$147.79	$237.98
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $258.10 / $520.33 / $829.36	Professional	TC	$258.10	$520.33	$829.36
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 $568.58 / $765.53 / $954.48	Professional		$568.58	$765.53	$954.48
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $146.63 / $174.75 / $232.14	Professional	26	$146.63	$174.75	$232.14
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $421.94 / $566.97 / $797.27	Professional	TC	$421.94	$566.97	$797.27
United Facility/Professional Professional Modifier Low / Median / High Price $303.70 / $562.52 / $1,023.27	Professional		$303.70	$562.52	$1,023.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.45 / $92.53 / $251.91	Professional	26	$75.45	$92.53	$251.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $228.23 / $420.93 / $780.10	Professional	TC	$228.23	$420.93	$780.10