Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $275.42 / $467.74	Facility	26	$199.53	$275.42	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $562.34 / $2,344.23	Professional		$398.11	$562.34	$2,344.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $218.78 / $549.54	Professional	26	$120.23	$218.78	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $346.74 / $616.60	Professional	TC	$269.15	$346.74	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $741.31 / $1,318.26	Professional		$380.19	$741.31	$1,318.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $173.78 / $354.81	Professional	26	$107.15	$173.78	$354.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $512.86 / $1,000.00	Professional	TC	$263.03	$512.86	$1,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $812.83 / $1,000.00	Professional		$707.95	$812.83	$1,000.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $257.04 / $316.23	Professional	26	$229.09	$257.04	$316.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $549.54 / $676.08	Professional	TC	$478.63	$549.54	$676.08
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $245.47 / $467.74 / $467.74	Facility	26	$245.47	$467.74	$467.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $776.25 / $1,174.90	Professional		$549.54	$776.25	$1,174.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $245.47 / $380.19	Professional	26	$147.91	$245.47	$380.19
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $524.81 / $776.25	Professional	TC	$338.84	$524.81	$776.25
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $239.88 / $245.47	Facility	26	$199.53	$239.88	$245.47
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Professional		$446.68	$446.68	$446.68
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $208.93 / $257.04	Professional	26	$144.54	$208.93	$257.04
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $489.78 / $812.83	Professional	TC	$346.74	$489.78	$812.83
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $138.04 / $199.53	Facility	26	$30.20	$138.04	$199.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $831.76 / $1,174.90	Professional		$407.38	$831.76	$1,174.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $251.19 / $354.81	Professional	26	$120.23	$251.19	$354.81
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $616.60 / $933.25	Professional	TC	$263.03	$616.60	$933.25
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Facility	26	$1,548.82	$1,548.82	$1,548.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $851.14 / $1,047.13	Professional		$676.08	$851.14	$1,047.13
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $257.04 / $331.13	Professional	26	$218.78	$257.04	$331.13
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $588.84 / $741.31	Professional	TC	$467.74	$588.84	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $676.08 / $1,202.26	Professional		$363.08	$676.08	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $162.18 / $363.08	Professional	26	$109.65	$162.18	$363.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $501.19 / $851.14	Professional	TC	$251.19	$501.19	$851.14