Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.78 / $164.94 / $364.07	Facility	26	$105.78	$164.94	$364.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $378.45 / $2,250.00	Professional		$171.00	$378.45	$2,250.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.56 / $86.00 / $212.43	Professional	26	$68.56	$86.00	$212.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $285.00 / $898.98	Professional	TC	$119.70	$285.00	$898.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $679.91 / $851.26 / $1,114.35	Professional		$679.91	$851.26	$1,114.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.72 / $164.86 / $212.41	Professional	26	$118.72	$164.86	$212.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $561.20 / $702.63 / $917.54	Professional	TC	$561.20	$702.63	$917.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $410.23 / $916.64 / $978.57	Professional		$410.23	$916.64	$978.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $71.95 / $165.94 / $171.65	Professional	26	$71.95	$165.94	$171.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $338.27 / $747.98 / $806.92	Professional	TC	$338.27	$747.98	$806.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $622.84 / $714.56 / $1,238.13	Professional		$622.84	$714.56	$1,238.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $115.81 / $164.95 / $230.22	Professional	26	$115.81	$164.95	$230.22
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $507.03 / $722.13 / $1,018.65	Professional	TC	$507.03	$722.13	$1,018.65
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $105.62 / $143.47 / $146.72	Facility	26	$105.62	$143.47	$146.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $316.77 / $351.98 / $429.28	Professional		$316.77	$351.98	$429.28
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $90.05 / $129.63 / $150.41	Professional	26	$90.05	$129.63	$150.41
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $410.84 / $602.98 / $684.74	Professional	TC	$410.84	$602.98	$684.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $605.34 / $970.12 / $1,121.48	Professional		$605.34	$970.12	$1,121.48
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $115.92 / $148.63 / $212.41	Professional	26	$115.92	$148.63	$212.41
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $466.14 / $686.41 / $903.50	Professional	TC	$466.14	$686.41	$903.50
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,526.97 / $1,526.97 / $1,526.97	Facility	26	$1,526.97	$1,526.97	$1,526.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $760.06 / $887.78 / $1,155.00	Professional		$760.06	$887.78	$1,155.00
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $136.71 / $172.00 / $205.61	Professional	26	$136.71	$172.00	$205.61
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $623.41 / $733.16 / $949.40	Professional	TC	$623.41	$733.16	$949.40
United Facility/Professional Professional Modifier Low / Median / High Price $363.16 / $391.43 / $1,296.88	Professional		$363.16	$391.43	$1,296.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.28 / $84.25 / $230.88	Professional	26	$66.28	$84.25	$230.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $296.88 / $324.55 / $1,083.35	Professional	TC	$296.88	$324.55	$1,083.35