Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $87.10 / $107.15	Facility	26	$54.95	$87.10	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $251.19	Professional		$70.79	$102.33	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $41.69 / $93.33	Professional	26	$32.36	$41.69	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $194.98 / $316.23	Professional		$100.00	$194.98	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $77.62 / $120.23	Professional	26	$43.65	$77.62	$120.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $239.88 / $302.00	Professional		$213.80	$239.88	$302.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $89.13 / $107.15	Professional	26	$77.62	$89.13	$107.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $213.80 / $309.03	Professional		$141.25	$213.80	$309.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $85.11 / $120.23	Professional	26	$66.07	$85.11	$120.23
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $79.43 / $83.18	Facility	26	$67.61	$79.43	$83.18
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $70.79 / $89.13	Professional	26	$48.98	$70.79	$89.13
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $47.86 / $67.61	Facility	26	$10.23	$47.86	$67.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $213.80 / $316.23	Professional		$158.49	$213.80	$316.23
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $83.18 / $120.23	Professional	26	$57.54	$83.18	$120.23
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $776.25 / $776.25 / $776.25	Facility	26	$776.25	$776.25	$776.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $218.78 / $288.40	Professional		$165.96	$218.78	$288.40
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $85.11 / $109.65	Professional	26	$72.44	$85.11	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $288.40	Professional		$91.20	$131.83	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $50.12 / $109.65	Professional	26	$39.81	$50.12	$109.65