Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $194.98 / $223.87	Facility	26	$138.04	$194.98	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $354.81 / $724.44	Professional		$223.87	$354.81	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $104.71 / $295.12	Professional	26	$74.13	$104.71	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $524.81 / $1,047.13	Professional		$302.00	$524.81	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $120.23 / $251.19	Professional	26	$75.86	$120.23	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $660.69 / $812.83	Professional		$575.44	$660.69	$812.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $177.83 / $218.78	Professional	26	$154.88	$177.83	$218.78
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $194.98 / $223.87	Facility	26	$104.71	$194.98	$223.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $645.65 / $891.25	Professional		$436.52	$645.65	$891.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $169.82 / $251.19	Professional	26	$102.33	$169.82	$251.19
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $165.96 / $169.82	Facility	26	$138.04	$165.96	$169.82
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $213.80 / $213.80	Professional		$165.96	$213.80	$213.80
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $147.91 / $181.97	Professional	26	$102.33	$147.91	$181.97
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $676.08 / $912.01	Professional		$331.13	$676.08	$912.01
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $173.78 / $245.47	Professional	26	$83.18	$173.78	$245.47
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 $549.54 / $660.69 / $851.14	Professional		$549.54	$660.69	$851.14
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $177.83 / $229.09	Professional	26	$151.36	$177.83	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $467.74 / $912.01	Professional		$281.84	$467.74	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $109.65 / $245.47	Professional	26	$77.62	$109.65	$245.47