Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.35 / $105.67 / $213.30	Facility	26	$93.35	$105.67	$213.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.18 / $311.20 / $1,156.11	Professional		$140.18	$311.20	$1,156.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.19 / $251.70 / $957.35	Professional	TC	$111.19	$251.70	$957.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $366.97 / $494.30 / $646.42	Professional		$366.97	$494.30	$646.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $298.94 / $397.90 / $521.69	Professional	TC	$298.94	$397.90	$521.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $214.60 / $480.09 / $511.91	Professional		$214.60	$480.09	$511.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.45 / $97.89 / $101.26	Professional	26	$42.45	$97.89	$101.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $172.15 / $380.68 / $410.65	Professional	TC	$172.15	$380.68	$410.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $346.43 / $364.00 / $633.36	Professional		$346.43	$364.00	$633.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $258.32 / $367.92 / $513.52	Professional	TC	$258.32	$367.92	$513.52
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $62.02 / $83.85 / $88.43	Facility	26	$62.02	$83.85	$88.43
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $215.07 / $305.76 / $365.21	Professional	TC	$215.07	$305.76	$365.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $335.40 / $494.00 / $573.96	Professional		$335.40	$494.00	$573.96
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $293.86 / $383.30 / $521.69	Professional	TC	$293.86	$383.30	$521.69
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $4,053.27 / $4,053.27 / $4,053.27	Facility	26	$4,053.27	$4,053.27	$4,053.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $392.49 / $505.43 / $590.29	Professional		$392.49	$505.43	$590.29
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $312.48 / $402.05 / $469.96	Professional	TC	$312.48	$402.05	$469.96
United Facility/Professional Professional Modifier Low / Median / High Price $196.02 / $246.84 / $691.54	Professional		$196.02	$246.84	$691.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.76 / $195.73 / $527.69	Professional	TC	$156.76	$195.73	$527.69