Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.06 / $86.19 / $190.62	Facility	26	$65.06	$86.19	$190.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $121.96 / $312.08	Professional		$96.60	$121.96	$312.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.42 / $40.40 / $103.75	Professional	26	$21.42	$40.40	$103.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	26	$43.62	$43.62	$43.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.11 / $216.98 / $345.41	Professional		$109.11	$216.98	$345.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.06 / $63.85 / $103.81	Professional	26	$27.06	$63.85	$103.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $237.44 / $281.69 / $325.60	Professional		$237.44	$281.69	$325.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $72.90 / $87.12 / $98.09	Professional	26	$72.90	$87.12	$98.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $166.98 / $203.79 / $378.18	Professional		$166.98	$203.79	$378.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.90 / $74.50 / $115.89	Professional	26	$42.90	$74.50	$115.89
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $38.76 / $64.98 / $77.52	Facility	26	$38.76	$64.98	$77.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $78.25 / $78.25 / $78.25	Professional		$78.25	$78.25	$78.25
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $31.42 / $43.52 / $75.70	Professional	26	$31.42	$43.52	$75.70
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	26	$43.62	$43.62	$43.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $175.46 / $255.54 / $354.05	Professional		$175.46	$255.54	$354.05
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $34.61 / $64.45 / $107.00	Professional	26	$34.61	$64.45	$107.00
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $385.75 / $385.75 / $385.75	Facility	26	$385.75	$385.75	$385.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $200.08 / $253.05 / $344.82	Professional		$200.08	$253.05	$344.82
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $42.88 / $76.72 / $108.02	Professional	26	$42.88	$76.72	$108.02
United Facility/Professional Professional Modifier Low / Median / High Price $104.55 / $123.07 / $351.92	Professional		$104.55	$123.07	$351.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.43 / $47.62 / $120.15	Professional	26	$24.43	$47.62	$120.15