Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $30.90 / $38.02	Facility	26	$19.05	$30.90	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $239.88	Professional		$64.57	$93.33	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $40.74	Professional	26	$12.02	$15.14	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $177.83 / $302.00	Professional		$85.11	$177.83	$302.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $28.18 / $44.67	Professional	26	$16.60	$28.18	$44.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $223.87 / $281.84	Professional		$194.98	$223.87	$281.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $32.36 / $38.90	Professional	26	$28.84	$32.36	$38.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $309.03	Professional		$109.65	$181.97	$309.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.90 / $44.67	Professional	26	$24.55	$30.90	$44.67
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $29.51 / $30.90	Facility	26	$24.55	$29.51	$30.90
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $25.12 / $31.62	Professional	26	$17.78	$25.12	$31.62
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.72 / $17.38 / $24.55	Facility	26	$3.72	$17.38	$24.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $302.00	Professional		$134.90	$199.53	$302.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $30.90 / $43.65	Professional	26	$20.42	$30.90	$43.65
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	26	$208.93	$208.93	$208.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $199.53 / $269.15	Professional		$147.91	$199.53	$269.15
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $31.62 / $40.74	Professional	26	$26.30	$31.62	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $263.03	Professional		$77.62	$104.71	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $18.62 / $40.74	Professional	26	$14.79	$18.62	$40.74