Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $134.90 / $151.36	Facility	26	$95.50	$134.90	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $223.87 / $549.54	Professional		$165.96	$223.87	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $61.66 / $134.90	Professional	26	$42.66	$61.66	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $407.38 / $645.65	Professional		$194.98	$407.38	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $104.71 / $169.82	Professional	26	$53.70	$104.71	$169.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $467.74 / $588.84	Professional		$407.38	$467.74	$588.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $125.89 / $151.36	Professional	26	$109.65	$125.89	$151.36
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $151.36 / $151.36	Facility	26	$117.49	$151.36	$151.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $407.38 / $645.65	Professional		$229.09	$407.38	$645.65
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $117.49 / $173.78	Professional	26	$66.07	$117.49	$173.78
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $102.33 / $120.23	Facility	26	$81.28	$102.33	$120.23
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $87.10 / $120.23	Professional	26	$64.57	$87.10	$120.23
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $97.72	Facility	26	$14.45	$67.61	$97.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $457.09 / $645.65	Professional		$346.74	$457.09	$645.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $169.82	Professional	26	$72.44	$104.71	$169.82
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 $389.05 / $467.74 / $602.56	Professional		$389.05	$467.74	$602.56
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $114.82 / $162.18	Professional	26	$87.10	$114.82	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $245.47 / $588.84	Professional		$181.97	$245.47	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $66.07 / $154.88	Professional	26	$51.29	$66.07	$154.88