Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $52.48 / $57.54	Facility	26	$30.90	$52.48	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $316.23	Professional		$91.20	$128.82	$316.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $22.91 / $52.48	Professional	26	$18.20	$22.91	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $239.88 / $380.19	Professional		$109.65	$239.88	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $43.65 / $67.61	Professional	26	$25.12	$43.65	$67.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $295.12 / $363.08	Professional		$257.04	$295.12	$363.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $48.98 / $58.88	Professional	26	$42.66	$48.98	$58.88
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $53.70 / $53.70	Facility	26	$53.70	$53.70	$53.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $251.19 / $398.11	Professional		$151.36	$251.19	$398.11
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $46.77 / $67.61	Professional	26	$37.15	$46.77	$67.61
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $44.67 / $46.77	Facility	26	$37.15	$44.67	$46.77
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $41.69 / $46.77	Professional	26	$28.18	$41.69	$46.77
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $37.15	Facility	26	$5.62	$26.30	$37.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $269.15 / $389.05	Professional		$190.55	$269.15	$389.05
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $47.86 / $67.61	Professional	26	$32.36	$47.86	$67.61
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 $208.93 / $269.15 / $363.08	Professional		$208.93	$269.15	$363.08
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $48.98 / $63.10	Professional	26	$41.69	$48.98	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $138.04 / $354.81	Professional		$109.65	$138.04	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $29.51 / $64.57	Professional	26	$23.44	$29.51	$64.57