Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.64 / $52.54 / $116.08	Facility	26	$49.64	$52.54	$116.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.58 / $133.04 / $368.48	Professional		$90.58	$133.04	$368.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.73 / $25.84 / $58.97	Professional	26	$14.73	$25.84	$58.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.63 / $26.63 / $26.63	Facility	26	$26.63	$26.63	$26.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.96 / $239.81 / $378.35	Professional		$117.96	$239.81	$378.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.37 / $45.25 / $67.51	Professional	26	$26.37	$45.25	$67.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $261.81 / $311.92 / $362.65	Professional		$261.81	$311.92	$362.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.59 / $52.05 / $58.60	Professional	26	$43.59	$52.05	$58.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $167.00 / $218.40 / $414.53	Professional		$167.00	$218.40	$414.53
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.29 / $45.56 / $71.16	Professional	26	$36.29	$45.56	$71.16
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $34.29 / $44.92 / $46.90	Facility	26	$34.29	$44.92	$46.90
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $41.04 / $50.18	Professional	26	$28.14	$41.04	$50.18
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.63 / $26.63 / $26.63	Facility	26	$26.63	$26.63	$26.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $189.10 / $276.37 / $392.35	Professional		$189.10	$276.37	$392.35
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.80 / $47.39 / $67.84	Professional	26	$30.80	$47.39	$67.84
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 $208.01 / $277.43 / $376.70	Professional		$208.01	$277.43	$376.70
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $41.90 / $49.53 / $66.17	Professional	26	$41.90	$49.53	$66.17
United Facility/Professional Professional Modifier Low / Median / High Price $109.96 / $154.91 / $371.51	Professional		$109.96	$154.91	$371.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.72 / $27.59 / $71.20	Professional	26	$23.72	$27.59	$71.20