Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.87 / $75.12 / $152.56	Facility	26	$58.87	$75.12	$152.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.54 / $142.63 / $299.63	Professional		$97.54	$142.63	$299.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.77 / $29.97 / $67.18	Professional	26	$18.77	$29.97	$67.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	26	$34.86	$34.86	$34.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.00 / $236.42 / $390.18	Professional		$130.00	$236.42	$390.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.97 / $54.18 / $79.70	Professional	26	$30.97	$54.18	$79.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $212.33 / $252.62 / $292.29	Professional		$212.33	$252.62	$292.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.51 / $69.04 / $77.73	Professional	26	$57.51	$69.04	$77.73
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.50 / $215.04 / $342.69	Professional		$173.50	$215.04	$342.69
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.58 / $59.47 / $91.50	Professional	26	$48.58	$59.47	$91.50
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $39.69 / $54.94 / $60.97	Facility	26	$39.69	$54.94	$60.97
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $33.36 / $47.31 / $59.20	Professional	26	$33.36	$47.31	$59.20
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	26	$34.86	$34.86	$34.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $191.16 / $280.87 / $401.28	Professional		$191.16	$280.87	$401.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $38.04 / $56.82 / $82.67	Professional	26	$38.04	$56.82	$82.67
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,538.06 / $1,538.06 / $1,538.06	Facility	26	$1,538.06	$1,538.06	$1,538.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $223.44 / $270.70 / $368.26	Professional		$223.44	$270.70	$368.26
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $51.66 / $62.33 / $81.88	Professional	26	$51.66	$62.33	$81.88
United Facility/Professional Professional Modifier Low / Median / High Price $115.71 / $138.58 / $393.20	Professional		$115.71	$138.58	$393.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.75 / $36.35 / $84.62	Professional	26	$28.75	$36.35	$84.62