Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $202.01 / $230.44 / $465.94	Facility	26	$202.01	$230.44	$465.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.61 / $204.30 / $433.56	Professional		$95.61	$204.30	$433.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.45 / $75.31 / $170.99	Professional	TC	$33.45	$75.31	$170.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.36 / $312.43 / $408.39	Professional		$221.36	$312.43	$408.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.94 / $118.31 / $151.05	Professional	TC	$75.94	$118.31	$151.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $285.17 / $338.35 / $386.27	Professional		$285.17	$338.35	$386.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $175.57 / $211.42 / $237.82	Professional	26	$175.57	$211.42	$237.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $109.58 / $126.46 / $148.43	Professional	TC	$109.58	$126.46	$148.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $214.20 / $255.26 / $445.29	Professional		$214.20	$255.26	$445.29
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.93 / $122.39 / $170.82	Professional	TC	$85.93	$122.39	$170.82
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $132.79 / $182.13 / $187.68	Facility	26	$132.79	$182.13	$187.68
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $63.11 / $88.33 / $113.40	Professional	TC	$63.11	$88.33	$113.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $239.54 / $328.25 / $422.92	Professional		$239.54	$328.25	$422.92
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $71.12 / $114.31 / $151.05	Professional	TC	$71.12	$114.31	$151.05
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $803.73 / $803.73 / $803.73	Facility	26	$803.73	$803.73	$803.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $262.14 / $340.13 / $415.01	Professional		$262.14	$340.13	$415.01
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $95.76 / $125.02 / $151.60	Professional	TC	$95.76	$125.02	$151.60
United Facility/Professional Professional Modifier Low / Median / High Price $123.09 / $240.35 / $484.66	Professional		$123.09	$240.35	$484.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.23 / $64.31 / $170.22	Professional	TC	$41.23	$64.31	$170.22