Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.73 / $96.64 / $107.69	Facility	26	$87.73	$96.64	$107.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.67 / $110.27 / $258.08	Professional		$87.67	$110.27	$258.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.67 / $59.52 / $138.30	Professional	26	$40.67	$59.52	$138.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.38 / $189.24 / $254.70	Professional		$122.38	$189.24	$254.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.72 / $99.27 / $142.44	Professional	26	$65.72	$99.27	$142.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.58 / $201.91 / $229.77	Professional		$139.58	$201.91	$229.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.67 / $100.72 / $113.40	Professional	26	$70.67	$100.72	$113.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $132.60 / $155.52 / $281.16	Professional		$132.60	$155.52	$281.16
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.18 / $95.10 / $147.47	Professional	26	$74.18	$95.10	$147.47
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $66.38 / $85.80 / $91.79	Facility	26	$66.38	$85.80	$91.79
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $52.97 / $69.18 / $69.18	Professional		$52.97	$69.18	$69.18
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $54.66 / $76.56 / $101.25	Professional	26	$54.66	$76.56	$101.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $148.84 / $194.71 / $250.71	Professional		$148.84	$194.71	$250.71
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $68.90 / $99.27 / $134.72	Professional	26	$68.90	$99.27	$134.72
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $882.62 / $882.62 / $882.62	Facility	26	$882.62	$882.62	$882.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $154.97 / $212.51 / $268.58	Professional		$154.97	$212.51	$268.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $84.26 / $112.41 / $143.71	Professional	26	$84.26	$112.41	$143.71
United Facility/Professional Professional Modifier Low / Median / High Price $122.43 / $186.97 / $268.12	Professional		$122.43	$186.97	$268.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.81 / $105.62 / $144.41	Professional	26	$71.81	$105.62	$144.41