Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.05 / $102.79 / $208.35	Facility	26	$87.05	$102.79	$208.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $115.87 / $294.75	Professional		$70.20	$115.87	$294.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.28 / $45.50 / $105.84	Professional	26	$27.28	$45.50	$105.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.27 / $47.27 / $47.27	Facility	26	$47.27	$47.27	$47.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.35 / $191.00 / $307.89	Professional		$103.35	$191.00	$307.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.51 / $78.45 / $116.28	Professional	26	$44.51	$78.45	$116.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $221.18 / $262.02 / $302.57	Professional		$221.18	$262.02	$302.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $80.20 / $96.17 / $108.39	Professional	26	$80.20	$96.17	$108.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $151.19 / $189.63 / $330.39	Professional		$151.19	$189.63	$330.39
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.70 / $79.55 / $124.02	Professional	26	$66.70	$79.55	$124.02
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $59.29 / $79.73 / $82.41	Facility	26	$59.29	$79.73	$82.41
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $49.98 / $70.18 / $87.04	Professional	26	$49.98	$70.18	$87.04
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $47.27 / $47.27 / $47.27	Facility	26	$47.27	$47.27	$47.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $153.16 / $224.58 / $303.61	Professional		$153.16	$224.58	$303.61
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $53.91 / $80.67 / $119.55	Professional	26	$53.91	$80.67	$119.55
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $782.93 / $782.93 / $782.93	Facility	26	$782.93	$782.93	$782.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $170.80 / $224.68 / $300.77	Professional		$170.80	$224.68	$300.77
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $73.02 / $85.61 / $115.60	Professional	26	$73.02	$85.61	$115.60
United Facility/Professional Professional Modifier Low / Median / High Price $91.16 / $142.16 / $313.18	Professional		$91.16	$142.16	$313.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.71 / $56.48 / $124.88	Professional	26	$42.71	$56.48	$124.88