Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $135.93 / $135.93 / $189.43	Facility	26	$135.93	$135.93	$189.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.98 / $435.74 / $960.99	Professional		$365.98	$435.74	$960.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.31 / $110.52 / $407.00	Professional	26	$81.31	$110.52	$407.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $284.67 / $342.98 / $770.53	Professional	TC	$284.67	$342.98	$770.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.38 / $96.38 / $96.38	Facility	26	$96.38	$96.38	$96.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $482.77 / $871.59 / $1,236.66	Professional		$482.77	$871.59	$1,236.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.61 / $176.40 / $239.55	Professional	26	$111.61	$176.40	$239.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $370.30 / $705.31 / $1,014.72	Professional	TC	$370.30	$705.31	$1,014.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $801.33 / $1,044.82 / $1,215.26	Professional		$801.33	$1,044.82	$1,215.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $148.24 / $193.28 / $218.09	Professional	26	$148.24	$193.28	$218.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $653.11 / $849.23 / $997.15	Professional	TC	$653.11	$849.23	$997.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $483.78 / $773.80 / $1,303.29	Professional		$483.78	$773.80	$1,303.29
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $121.79 / $156.65 / $266.30	Professional	26	$121.79	$156.65	$266.30
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $301.32 / $620.69 / $1,143.74	Professional	TC	$301.32	$620.69	$1,143.74
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $124.46 / $165.97 / $172.04	Facility	26	$124.46	$165.97	$172.04
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $105.73 / $148.07 / $184.71	Professional	26	$105.73	$148.07	$184.71
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $364.21 / $552.04 / $757.84	Professional	TC	$364.21	$552.04	$757.84
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $96.38 / $96.38 / $96.38	Facility	26	$96.38	$96.38	$96.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $560.17 / $919.55 / $1,179.44	Professional		$560.17	$919.55	$1,179.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $113.37 / $176.40 / $239.55	Professional	26	$113.37	$176.40	$239.55
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $380.21 / $730.03 / $1,014.72	Professional	TC	$380.21	$730.03	$1,014.72
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $838.61 / $838.61 / $838.61	Facility	26	$838.61	$838.61	$838.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $661.68 / $854.45 / $1,214.70	Professional		$661.68	$854.45	$1,214.70
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $135.00 / $170.14 / $236.88	Professional	26	$135.00	$170.14	$236.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $536.30 / $687.83 / $977.82	Professional	TC	$536.30	$687.83	$977.82
United Facility/Professional Professional Modifier Low / Median / High Price $598.23 / $934.08 / $1,328.14	Professional		$598.23	$934.08	$1,328.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $127.25 / $182.00 / $259.01	Professional	26	$127.25	$182.00	$259.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $471.11 / $740.83 / $1,060.76	Professional	TC	$471.11	$740.83	$1,060.76