Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $125.89 / $144.54	Facility	26	$85.11	$125.89	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $309.03 / $616.60	Professional		$218.78	$309.03	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $144.54	Professional	26	$51.29	$64.57	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $457.09 / $870.96	Professional		$263.03	$457.09	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $85.11 / $169.82	Professional	26	$53.70	$85.11	$169.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $549.54 / $676.08	Professional		$478.63	$549.54	$676.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $120.23 / $147.91	Professional	26	$104.71	$120.23	$147.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $537.03 / $758.58	Professional		$407.38	$537.03	$758.58
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $114.82 / $169.82	Professional	26	$87.10	$114.82	$169.82
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $112.20 / $117.49	Facility	26	$93.33	$112.20	$117.49
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $199.53	Professional		$177.83	$177.83	$199.53
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $104.71 / $128.82	Professional	26	$69.18	$104.71	$128.82
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $93.33	Facility	26	$13.80	$64.57	$93.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $562.34 / $758.58	Professional		$281.84	$562.34	$758.58
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $117.49 / $169.82	Professional	26	$56.23	$117.49	$169.82
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $851.14 / $851.14 / $851.14	Facility	26	$851.14	$851.14	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $562.34 / $724.44	Professional		$467.74	$562.34	$724.44
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $123.03 / $158.49	Professional	26	$102.33	$123.03	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $380.19 / $776.25	Professional		$239.88	$380.19	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $74.13 / $165.96	Professional	26	$52.48	$74.13	$165.96