Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.26 / $149.28 / $301.70	Facility	26	$129.26	$149.28	$301.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $371.00 / $552.30	Professional		$174.81	$371.00	$552.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $74.53 / $153.26	Professional	26	$51.30	$74.53	$153.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.65 / $473.34 / $678.73	Professional		$219.65	$473.34	$678.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.36 / $108.34 / $175.93	Professional	26	$59.36	$108.34	$175.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $399.02 / $448.52 / $548.02	Professional		$399.02	$448.52	$548.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $114.54 / $131.85 / $154.11	Professional	26	$114.54	$131.85	$154.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $340.52 / $459.90 / $666.24	Professional		$340.52	$459.90	$666.24
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.54 / $118.59 / $183.00	Professional	26	$95.54	$118.59	$183.00
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $88.69 / $118.06 / $121.27	Facility	26	$88.69	$118.06	$121.27
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $72.40 / $106.20 / $127.61	Professional	26	$72.40	$106.20	$127.61
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $352.73 / $497.86 / $637.04	Professional		$352.73	$497.86	$637.04
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $61.95 / $108.51 / $176.02	Professional	26	$61.95	$108.51	$176.02
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 $371.07 / $499.97 / $622.39	Professional		$371.07	$499.97	$622.39
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $107.73 / $127.35 / $170.55	Professional	26	$107.73	$127.35	$170.55
United Facility/Professional Professional Modifier Low / Median / High Price $199.09 / $337.48 / $670.80	Professional		$199.09	$337.48	$670.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.98 / $74.48 / $185.76	Professional	26	$54.98	$74.48	$185.76