Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $261.32 / $261.32 / $290.19	Facility	26	$261.32	$261.32	$290.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $348.98 / $455.50 / $821.12	Professional	TC	$348.98	$455.50	$821.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.76 / $132.76 / $132.76	Facility	26	$132.76	$132.76	$132.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $461.78 / $868.11 / $1,229.29	Professional	TC	$461.78	$868.11	$1,229.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $205.30 / $267.69 / $301.87	Professional	26	$205.30	$267.69	$301.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $791.22 / $1,028.81 / $1,208.01	Professional	TC	$791.22	$1,028.81	$1,208.01
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $697.04 / $844.90 / $1,385.64	Professional	TC	$697.04	$844.90	$1,385.64
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $167.09 / $228.47 / $232.49	Facility	26	$167.09	$228.47	$232.49
Pacific Source Facility/Professional Professional Modifier TC Low / Median / High Price $463.83 / $718.24 / $889.09	Professional	TC	$463.83	$718.24	$889.09
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $132.76 / $132.76 / $132.76	Facility	26	$132.76	$132.76	$132.76
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $461.78 / $921.39 / $1,248.28	Professional	TC	$461.78	$921.39	$1,248.28
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $3,043.22 / $3,043.22 / $3,043.22	Facility	26	$3,043.22	$3,043.22	$3,043.22
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $660.18 / $857.12 / $1,218.48	Professional	TC	$660.18	$857.12	$1,218.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $617.21 / $788.66 / $1,355.44	Professional	TC	$617.21	$788.66	$1,355.44