Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.32 / $63.36 / $88.05	Facility	26	$48.32	$63.36	$88.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.96 / $227.55 / $918.85	Professional		$179.96	$227.55	$918.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $40.94 / $121.00	Professional	26	$28.30	$40.94	$121.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.80 / $184.00 / $451.72	Professional	TC	$151.80	$184.00	$451.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.83 / $425.54 / $600.01	Professional		$247.83	$425.54	$600.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.64 / $75.11 / $116.67	Professional	26	$40.64	$75.11	$116.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.35 / $346.66 / $518.33	Professional	TC	$208.35	$346.66	$518.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $358.92 / $418.27 / $511.39	Professional		$358.92	$418.27	$511.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.02 / $82.95 / $95.62	Professional	26	$70.02	$82.95	$95.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $287.74 / $336.67 / $415.79	Professional	TC	$287.74	$336.67	$415.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $299.95 / $370.85 / $582.51	Professional		$299.95	$370.85	$582.51
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.95 / $72.42 / $118.83	Professional	26	$56.95	$72.42	$118.83
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $240.17 / $327.51 / $477.44	Professional	TC	$240.17	$327.51	$477.44
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $55.23 / $73.36 / $76.38	Facility	26	$55.23	$73.36	$76.38
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $41.18 / $55.47 / $80.37	Professional	26	$41.18	$55.47	$80.37
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $209.30 / $302.17 / $382.22	Professional	TC	$209.30	$302.17	$382.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $347.79 / $436.05 / $558.72	Professional		$347.79	$436.05	$558.72
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $45.79 / $77.33 / $109.17	Professional	26	$45.79	$77.33	$109.17
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $216.47 / $353.65 / $480.48	Professional	TC	$216.47	$353.65	$480.48
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $782.93 / $782.93 / $782.93	Facility	26	$782.93	$782.93	$782.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $348.40 / $449.22 / $542.91	Professional		$348.40	$449.22	$542.91
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $55.72 / $87.42 / $107.07	Professional	26	$55.72	$87.42	$107.07
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $291.26 / $372.19 / $435.85	Professional	TC	$291.26	$372.19	$435.85
United Facility/Professional Professional Modifier Low / Median / High Price $232.09 / $383.53 / $593.62	Professional		$232.09	$383.53	$593.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.13 / $74.58 / $125.42	Professional	26	$42.13	$74.58	$125.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $193.56 / $311.20 / $476.56	Professional	TC	$193.56	$311.20	$476.56