Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $185.07 / $245.91 / $544.70	Facility	26	$185.07	$245.91	$544.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $340.28 / $494.18 / $1,320.50	Professional		$340.28	$494.18	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.40 / $150.18 / $465.10	Professional	26	$90.40	$150.18	$465.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.20 / $335.00 / $613.45	Professional	TC	$190.20	$335.00	$613.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.62 / $124.62 / $124.62	Facility	26	$124.62	$124.62	$124.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.01 / $700.52 / $1,039.43	Professional		$373.01	$700.52	$1,039.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.87 / $195.04 / $316.87	Professional	26	$107.87	$195.04	$316.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.35 / $502.00 / $750.18	Professional	TC	$263.35	$502.00	$750.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $686.19 / $785.36 / $941.33	Professional		$686.19	$785.36	$941.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $208.12 / $239.58 / $280.06	Professional	26	$208.12	$239.58	$280.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $471.66 / $547.08 / $661.27	Professional	TC	$471.66	$547.08	$661.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $555.60 / $733.75 / $1,104.47	Professional		$555.60	$733.75	$1,104.47
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $173.99 / $229.88 / $345.88	Professional	26	$173.99	$229.88	$345.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $381.61 / $539.92 / $763.47	Professional	TC	$381.61	$539.92	$763.47
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $142.12 / $214.53 / $218.42	Facility	26	$142.12	$214.53	$218.42
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $128.72 / $177.65 / $216.41	Professional	26	$128.72	$177.65	$216.41
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $393.21 / $471.65 / $491.78	Professional	TC	$393.21	$471.65	$491.78
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $124.62 / $124.62 / $124.62	Facility	26	$124.62	$124.62	$124.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $541.03 / $785.90 / $1,034.38	Professional		$541.03	$785.90	$1,034.38
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $110.04 / $195.04 / $317.63	Professional	26	$110.04	$195.04	$317.63
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $269.08 / $506.21 / $771.24	Professional	TC	$269.08	$506.21	$771.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $643.99 / $830.09 / $1,033.84	Professional		$643.99	$830.09	$1,033.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $194.51 / $240.63 / $307.94	Professional	26	$194.51	$240.63	$307.94
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $449.47 / $575.86 / $717.93	Professional	TC	$449.47	$575.86	$717.93
United Facility/Professional Professional Modifier Low / Median / High Price $343.26 / $594.22 / $1,190.59	Professional		$343.26	$594.22	$1,190.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.06 / $129.02 / $336.43	Professional	26	$74.06	$129.02	$336.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $243.26 / $412.36 / $831.00	Professional	TC	$243.26	$412.36	$831.00