Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $259.89 / $259.89 / $385.89	Facility	26	$259.89	$259.89	$385.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.78 / $316.00 / $1,055.31	Professional		$248.78	$316.00	$1,055.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.25 / $168.77 / $382.21	Professional	26	$144.25	$168.77	$382.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.80 / $114.67 / $207.57	Professional	TC	$89.80	$114.67	$207.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $176.41 / $176.41 / $176.41	Facility	26	$176.41	$176.41	$176.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.07 / $536.72 / $727.70	Professional		$339.07	$536.72	$727.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $202.81 / $324.14 / $440.85	Professional	26	$202.81	$324.14	$440.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $132.00 / $214.54 / $284.39	Professional	TC	$132.00	$214.54	$284.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $432.38 / $563.76 / $644.60	Professional		$432.38	$563.76	$644.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $272.57 / $355.39 / $400.73	Professional	26	$272.57	$355.39	$400.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $159.81 / $207.70 / $243.84	Professional	TC	$159.81	$207.70	$243.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $387.49 / $460.66 / $749.25	Professional		$387.49	$460.66	$749.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $246.58 / $298.88 / $490.16	Professional	26	$246.58	$298.88	$490.16
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $140.88 / $170.78 / $280.08	Professional	TC	$140.88	$170.78	$280.08
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $219.48 / $303.51 / $308.87	Facility	26	$219.48	$303.51	$308.87
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $185.32 / $271.80 / $335.22	Professional	26	$185.32	$271.80	$335.22
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $117.79 / $173.94 / $208.68	Professional	TC	$117.79	$173.94	$208.68
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $176.41 / $176.41 / $176.41	Facility	26	$176.41	$176.41	$176.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $337.49 / $534.96 / $698.79	Professional		$337.49	$534.96	$698.79
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $208.38 / $324.14 / $440.85	Professional	26	$208.38	$324.14	$440.85
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $129.11 / $214.54 / $287.91	Professional	TC	$129.11	$214.54	$287.91
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,497.68 / $1,497.68 / $1,497.68	Facility	26	$1,497.68	$1,497.68	$1,497.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $397.98 / $502.68 / $698.31	Professional		$397.98	$502.68	$698.31
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $247.86 / $305.92 / $434.90	Professional	26	$247.86	$305.92	$434.90
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $150.12 / $199.10 / $263.39	Professional	TC	$150.12	$199.10	$263.39
United Facility/Professional Professional Modifier Low / Median / High Price $375.13 / $520.11 / $767.97	Professional		$375.13	$520.11	$767.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $228.50 / $329.23 / $483.78	Professional	26	$228.50	$329.23	$483.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.94 / $213.91 / $295.77	Professional	TC	$132.94	$213.91	$295.77