Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.15 / $112.51 / $249.38	Facility	26	$84.15	$112.51	$249.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.73 / $398.56 / $1,899.00	Professional		$318.73	$398.56	$1,899.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.85 / $50.84 / $226.23	Professional	26	$45.85	$50.84	$226.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $211.62 / $334.82 / $829.75	Professional	TC	$211.62	$334.82	$829.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $562.98 / $847.70 / $982.45	Professional		$562.98	$847.70	$982.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.70 / $112.48 / $142.56	Professional	26	$79.70	$112.48	$142.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $483.28 / $735.22 / $840.63	Professional	TC	$483.28	$735.22	$840.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $357.53 / $797.51 / $852.86	Professional		$357.53	$797.51	$852.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $49.09 / $113.20 / $117.10	Professional	26	$49.09	$113.20	$117.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $308.44 / $682.02 / $735.76	Professional	TC	$308.44	$682.02	$735.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $525.29 / $609.17 / $1,075.81	Professional		$525.29	$609.17	$1,075.81
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.98 / $101.17 / $157.01	Professional	26	$78.98	$101.17	$157.01
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $462.20 / $570.84 / $918.79	Professional	TC	$462.20	$570.84	$918.79
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $71.70 / $97.87 / $99.96	Facility	26	$71.70	$97.87	$99.96
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $316.77 / $857.90 / $857.90	Professional		$316.77	$857.90	$857.90
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $59.50 / $86.43 / $108.04	Professional	26	$59.50	$86.43	$108.04
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $357.42 / $487.20 / $649.72	Professional	TC	$357.42	$487.20	$649.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $506.20 / $787.35 / $977.96	Professional		$506.20	$787.35	$977.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $77.83 / $99.79 / $142.56	Professional	26	$77.83	$99.79	$142.56
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $471.91 / $609.97 / $840.63	Professional	TC	$471.91	$609.97	$840.63
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 $633.45 / $773.78 / $1,007.19	Professional		$633.45	$773.78	$1,007.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $89.67 / $116.24 / $140.22	Professional	26	$89.67	$116.24	$140.22
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $543.04 / $669.04 / $866.96	Professional	TC	$543.04	$669.04	$866.96
United Facility/Professional Professional Modifier Low / Median / High Price $302.07 / $364.10 / $1,138.70	Professional		$302.07	$364.10	$1,138.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.20 / $45.70 / $157.44	Professional	26	$45.20	$45.70	$157.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $256.87 / $357.11 / $973.47	Professional	TC	$256.87	$357.11	$973.47