Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $241.57 / $302.02 / $610.04	Facility	26	$241.57	$302.02	$610.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $408.44 / $519.83 / $2,372.59	Professional		$408.44	$519.83	$2,372.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.00 / $154.00 / $439.23	Professional	26	$104.00	$154.00	$439.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $275.16 / $348.53 / $700.62	Professional	TC	$275.16	$348.53	$700.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $401.86 / $772.83 / $1,194.57	Professional		$401.86	$772.83	$1,194.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.69 / $217.48 / $352.83	Professional	26	$120.69	$217.48	$352.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $278.63 / $548.35 / $841.74	Professional	TC	$278.63	$548.35	$841.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $723.70 / $840.88 / $991.28	Professional		$723.70	$840.88	$991.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $232.98 / $268.19 / $313.33	Professional	26	$232.98	$268.19	$313.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $483.55 / $572.99 / $677.94	Professional	TC	$483.55	$572.99	$677.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $585.49 / $737.40 / $1,163.88	Professional		$585.49	$737.40	$1,163.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $194.27 / $251.25 / $369.03	Professional	26	$194.27	$251.25	$369.03
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $391.22 / $557.19 / $799.94	Professional	TC	$391.22	$557.19	$799.94
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $178.36 / $240.15 / $246.84	Facility	26	$178.36	$240.15	$246.84
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $268.35 / $268.35 / $268.35	Professional		$268.35	$268.35	$268.35
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $145.93 / $212.99 / $256.63	Professional	26	$145.93	$212.99	$256.63
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $341.30 / $501.35 / $813.16	Professional	TC	$341.30	$501.35	$813.16
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $611.35 / $891.20 / $1,124.23	Professional		$611.35	$891.20	$1,124.23
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $123.24 / $220.31 / $355.00	Professional	26	$123.24	$220.31	$355.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $278.63 / $548.35 / $860.96	Professional	TC	$278.63	$548.35	$860.96
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 $681.09 / $877.79 / $1,078.26	Professional		$681.09	$877.79	$1,078.26
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $217.26 / $256.82 / $343.94	Professional	26	$217.26	$256.82	$343.94
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $463.84 / $609.37 / $773.48	Professional	TC	$463.84	$609.37	$773.48
United Facility/Professional Professional Modifier Low / Median / High Price $362.59 / $554.54 / $1,210.36	Professional		$362.59	$554.54	$1,210.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.74 / $146.44 / $372.55	Professional	26	$110.74	$146.44	$372.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.68 / $503.71 / $857.55	Professional	TC	$251.68	$503.71	$857.55