Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.50 / $458.36 / $766.83	Facility		$94.50	$458.36	$766.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.14 / $77.18 / $176.38	Facility	26	$53.14	$77.18	$176.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.02 / $170.74 / $612.00	Professional		$119.02	$170.74	$612.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $52.91 / $183.00	Professional	26	$34.67	$52.91	$183.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.82 / $109.52 / $276.80	Professional	TC	$82.82	$109.52	$276.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.82 / $301.52 / $367.38	Facility		$86.82	$301.52	$367.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.01 / $259.79 / $354.25	Professional		$136.01	$259.79	$354.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.79 / $79.59 / $111.78	Professional	26	$43.79	$79.59	$111.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.33 / $177.20 / $232.08	Professional	TC	$92.33	$177.20	$232.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $221.14 / $257.72 / $312.27	Professional		$221.14	$257.72	$312.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $71.83 / $84.96 / $98.09	Professional	26	$71.83	$84.96	$98.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $148.24 / $173.43 / $214.19	Professional	TC	$148.24	$173.43	$214.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $119.92 / $220.58 / $357.00	Facility		$119.92	$220.58	$357.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $184.67 / $209.40 / $356.82	Professional		$184.67	$209.40	$356.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.85 / $74.50 / $120.97	Professional	26	$60.85	$74.50	$120.97
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.82 / $163.02 / $246.13	Professional	TC	$123.82	$163.02	$246.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $168.61 / $227.96 / $263.72	Facility		$168.61	$227.96	$263.72
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $56.35 / $75.15 / $77.72	Facility	26	$56.35	$75.15	$77.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $78.25 / $78.25 / $78.25	Professional		$78.25	$78.25	$78.25
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $46.23 / $65.55 / $83.81	Professional	26	$46.23	$65.55	$83.81
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $110.57 / $149.12 / $195.25	Professional	TC	$110.57	$149.12	$195.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $133.30 / $288.01 / $367.09	Facility		$133.30	$288.01	$367.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $209.06 / $263.33 / $341.83	Professional		$209.06	$263.33	$341.83
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $83.55 / $111.12	Professional	26	$51.32	$83.55	$111.12
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $108.27 / $183.51 / $232.08	Professional	TC	$108.27	$183.51	$232.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $312.19 / $372.00 / $463.05	Facility		$312.19	$372.00	$463.05
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $385.75 / $385.75 / $385.75	Facility	26	$385.75	$385.75	$385.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $214.64 / $279.83 / $332.77	Professional		$214.64	$279.83	$332.77
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $69.83 / $91.51 / $108.02	Professional	26	$69.83	$91.51	$108.02
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $148.84 / $191.76 / $224.56	Professional	TC	$148.84	$191.76	$224.56
United Facility/Professional Professional Modifier Low / Median / High Price $124.69 / $157.22 / $358.66	Professional		$124.69	$157.22	$358.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.27 / $45.32 / $119.89	Professional	26	$41.27	$45.32	$119.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.37 / $101.25 / $245.52	Professional	TC	$83.37	$101.25	$245.52