Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $653.90 / $944.93 / $2,128.25	Facility	26	$653.90	$944.93	$2,128.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,889.42 / $2,503.46 / $10,147.00	Professional		$1,889.42	$2,503.46	$10,147.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $360.87 / $531.63 / $1,814.71	Professional	26	$360.87	$531.63	$1,814.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,542.03 / $1,971.84 / $4,260.68	Professional	TC	$1,542.03	$1,971.84	$4,260.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,944.89 / $4,095.71 / $5,489.80	Professional		$2,944.89	$4,095.71	$5,489.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $599.08 / $893.86 / $1,153.13	Professional	26	$599.08	$893.86	$1,153.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2,345.81 / $3,201.85 / $4,341.88	Professional	TC	$2,345.81	$3,201.85	$4,341.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,738.30 / $4,361.55 / $5,063.59	Professional		$3,738.30	$4,361.55	$5,063.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $815.86 / $978.68 / $1,105.09	Professional	26	$815.86	$978.68	$1,105.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $2,922.44 / $3,371.72 / $3,958.49	Professional	TC	$2,922.44	$3,371.72	$3,958.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $2,966.40 / $3,254.05 / $5,585.28	Professional		$2,966.40	$3,254.05	$5,585.28
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $678.35 / $844.54 / $1,348.47	Professional	26	$678.35	$844.54	$1,348.47
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,288.04 / $3,258.72 / $4,548.34	Professional	TC	$2,288.04	$3,258.72	$4,548.34
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $568.32 / $785.91 / $836.83	Facility	26	$568.32	$785.91	$836.83
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $828.90 / $829.15 / $829.15	Professional		$828.90	$829.15	$829.15
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $469.20 / $698.40 / $920.21	Professional	26	$469.20	$698.40	$920.21
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $1,798.89 / $2,544.67 / $3,380.40	Professional	TC	$1,798.89	$2,544.67	$3,380.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,177.74 / $4,304.07 / $5,443.99	Professional		$3,177.74	$4,304.07	$5,443.99
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $554.02 / $881.15 / $1,153.13	Professional	26	$554.02	$881.15	$1,153.13
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $1,885.84 / $3,201.85 / $4,341.88	Professional	TC	$1,885.84	$3,201.85	$4,341.88
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $3,999.35 / $3,999.35 / $3,999.35	Facility	26	$3,999.35	$3,999.35	$3,999.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,461.22 / $4,323.63 / $5,205.56	Professional		$3,461.22	$4,323.63	$5,205.56
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $747.53 / $969.93 / $1,183.43	Professional	26	$747.53	$969.93	$1,183.43
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $2,674.35 / $3,387.43 / $4,022.14	Professional	TC	$2,674.35	$3,387.43	$4,022.14
United Facility/Professional Professional Modifier Low / Median / High Price $2,436.50 / $2,539.67 / $5,845.05	Professional		$2,436.50	$2,539.67	$5,845.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $498.91 / $540.89 / $1,328.81	Professional	26	$498.91	$540.89	$1,328.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,895.61 / $2,387.58 / $4,697.08	Professional	TC	$1,895.61	$2,387.58	$4,697.08