Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.96 / $125.96 / $139.59	Facility	26	$125.96	$125.96	$139.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.31 / $395.96 / $1,010.59	Professional		$316.31	$395.96	$1,010.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $264.98 / $333.35 / $736.64	Professional	TC	$264.98	$333.35	$736.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.30 / $839.58 / $1,156.58	Professional		$426.30	$839.58	$1,156.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $361.90 / $720.73 / $1,009.30	Professional	TC	$361.90	$720.73	$1,009.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $755.36 / $984.89 / $1,147.85	Professional		$755.36	$984.89	$1,147.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $98.02 / $127.80 / $144.19	Professional	26	$98.02	$127.80	$144.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $657.35 / $854.74 / $1,003.64	Professional	TC	$657.35	$854.74	$1,003.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $453.21 / $708.14 / $1,218.08	Professional		$453.21	$708.14	$1,218.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $280.86 / $624.71 / $1,151.15	Professional	TC	$280.86	$624.71	$1,151.15
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $79.94 / $108.12 / $111.89	Facility	26	$79.94	$108.12	$111.89
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $339.69 / $456.45 / $686.70	Professional	TC	$339.69	$456.45	$686.70
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $524.05 / $854.56 / $1,134.50	Professional		$524.05	$854.56	$1,134.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $361.90 / $743.97 / $1,021.32	Professional	TC	$361.90	$743.97	$1,021.32
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 $637.66 / $828.46 / $1,177.74	Professional		$637.66	$828.46	$1,177.74
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $552.50 / $717.82 / $1,020.46	Professional	TC	$552.50	$717.82	$1,020.46
United Facility/Professional Professional Modifier Low / Median / High Price $576.67 / $776.29 / $1,310.13	Professional		$576.67	$776.29	$1,310.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $393.79 / $647.08 / $1,055.83	Professional	TC	$393.79	$647.08	$1,055.83