Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.43 / $147.59 / $298.24	Facility	26	$117.43	$147.59	$298.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.58 / $223.43 / $915.00	Professional		$172.58	$223.43	$915.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $60.06 / $134.56	Professional	26	$42.60	$60.06	$134.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.29 / $68.29 / $68.29	Facility	26	$68.29	$68.29	$68.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.71 / $418.94 / $636.85	Professional		$200.71	$418.94	$636.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.86 / $100.55 / $165.20	Professional	26	$53.86	$100.55	$165.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $425.45 / $505.34 / $585.15	Professional		$425.45	$505.34	$585.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $113.25 / $135.31 / $152.35	Professional	26	$113.25	$135.31	$152.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $310.00 / $365.10 / $684.18	Professional		$310.00	$365.10	$684.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.76 / $115.65 / $180.96	Professional	26	$89.76	$115.65	$180.96
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $71.56 / $101.46 / $119.26	Facility	26	$71.56	$101.46	$119.26
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $140.29 / $140.29 / $140.29	Professional		$140.29	$140.29	$140.29
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $64.75 / $85.63 / $119.26	Professional	26	$64.75	$85.63	$119.26
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $68.29 / $68.29 / $68.29	Facility	26	$68.29	$68.29	$68.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $352.82 / $486.00 / $644.90	Professional		$352.82	$486.00	$644.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $71.17 / $109.07 / $165.20	Professional	26	$71.17	$109.07	$165.20
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 $398.52 / $458.01 / $630.60	Professional		$398.52	$458.01	$630.60
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $86.72 / $121.25 / $168.66	Professional	26	$86.72	$121.25	$168.66
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $263.23 / $672.93	Professional		$213.80	$263.23	$672.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.15 / $64.23 / $183.70	Professional	26	$50.15	$64.23	$183.70