Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.78 / $135.32 / $299.87	Facility	26	$105.78	$135.32	$299.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.29 / $371.00 / $548.64	Professional		$178.29	$371.00	$548.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.58 / $70.01 / $152.33	Professional	26	$52.58	$70.01	$152.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.19 / $470.25 / $674.19	Professional		$218.19	$470.25	$674.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.00 / $107.72 / $174.96	Professional	26	$59.00	$107.72	$174.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $394.40 / $446.76 / $541.53	Professional		$394.40	$446.76	$541.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $113.90 / $132.16 / $153.18	Professional	26	$113.90	$132.16	$153.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $336.57 / $454.56 / $661.12	Professional		$336.57	$454.56	$661.12
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.01 / $118.59 / $181.98	Professional	26	$95.01	$118.59	$181.98
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $88.69 / $117.40 / $121.27	Facility	26	$88.69	$117.40	$121.27
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $140.29 / $140.29 / $140.29	Professional		$140.29	$140.29	$140.29
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $72.36 / $108.00 / $125.93	Professional	26	$72.36	$108.00	$125.93
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $348.60 / $496.25 / $632.41	Professional		$348.60	$496.25	$632.41
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $61.78 / $108.51 / $175.04	Professional	26	$61.78	$108.51	$175.04
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $851.78 / $851.78 / $851.78	Facility	26	$851.78	$851.78	$851.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $367.48 / $496.79 / $621.42	Professional		$367.48	$496.79	$621.42
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $107.13 / $127.35 / $169.60	Professional	26	$107.13	$127.35	$169.60
United Facility/Professional Professional Modifier Low / Median / High Price $198.78 / $368.19 / $669.77	Professional		$198.78	$368.19	$669.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.98 / $79.33 / $185.76	Professional	26	$54.98	$79.33	$185.76