Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.01 / $97.74 / $197.60	Facility	26	$87.01	$97.74	$197.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.29 / $139.77 / $300.36	Professional		$73.29	$139.77	$300.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.27 / $46.61 / $100.38	Professional	26	$27.27	$46.61	$100.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.12 / $45.12 / $45.12	Facility	26	$45.12	$45.12	$45.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.38 / $214.46 / $312.05	Professional		$136.38	$214.46	$312.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.07 / $79.47 / $118.32	Professional	26	$45.07	$79.47	$118.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.96 / $244.53 / $299.50	Professional		$218.96	$244.53	$299.50
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $75.50 / $87.43 / $101.64	Professional	26	$75.50	$87.43	$101.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.40 / $193.30 / $352.24	Professional		$162.40	$193.30	$352.24
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.98 / $75.90 / $119.97	Professional	26	$62.98	$75.90	$119.97
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $60.76 / $77.81 / $82.41	Facility	26	$60.76	$77.81	$82.41
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $49.45 / $71.04 / $83.78	Professional	26	$49.45	$71.04	$83.78
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $45.12 / $45.12 / $45.12	Facility	26	$45.12	$45.12	$45.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $166.38 / $241.08 / $319.20	Professional		$166.38	$241.08	$319.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $53.91 / $81.48 / $118.32	Professional	26	$53.91	$81.48	$118.32
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,427.71 / $5,427.71 / $5,427.71	Facility	26	$5,427.71	$5,427.71	$5,427.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $187.27 / $228.79 / $308.27	Professional		$187.27	$228.79	$308.27
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $70.62 / $87.02 / $111.81	Professional	26	$70.62	$87.02	$111.81
United Facility/Professional Professional Modifier Low / Median / High Price $99.28 / $141.69 / $312.14	Professional		$99.28	$141.69	$312.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.11 / $48.47 / $123.91	Professional	26	$42.11	$48.47	$123.91