Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.78 / $191.01 / $422.48	Facility	26	$105.78	$191.01	$422.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.27 / $392.29 / $1,205.24	Professional		$230.27	$392.29	$1,205.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.56 / $92.75 / $378.59	Professional	26	$75.56	$92.75	$378.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.37 / $583.73 / $902.01	Professional		$328.37	$583.73	$902.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.17 / $152.56 / $246.06	Professional	26	$83.17	$152.56	$246.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $596.33 / $674.72 / $819.74	Professional		$596.33	$674.72	$819.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $161.56 / $185.98 / $217.18	Professional	26	$161.56	$185.98	$217.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $497.66 / $638.16 / $942.39	Professional		$497.66	$638.16	$942.39
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.04 / $172.19 / $257.19	Professional	26	$135.04	$172.19	$257.19
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $125.44 / $166.54 / $171.52	Facility	26	$125.44	$166.54	$171.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $140.29 / $155.88 / $270.36	Professional		$140.29	$155.88	$270.36
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $106.37 / $153.69 / $180.48	Professional	26	$106.37	$153.69	$180.48
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $482.44 / $688.20 / $894.44	Professional		$482.44	$688.20	$894.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $85.35 / $152.56 / $246.83	Professional	26	$85.35	$152.56	$246.83
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 $554.80 / $686.35 / $878.33	Professional		$554.80	$686.35	$878.33
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $151.41 / $180.41 / $239.72	Professional	26	$151.41	$180.41	$239.72
United Facility/Professional Professional Modifier Low / Median / High Price $282.79 / $399.05 / $953.57	Professional		$282.79	$399.05	$953.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.92 / $125.11 / $279.93	Professional	26	$77.92	$125.11	$279.93