Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.61 / $60.31 / $121.77	Facility	26	$54.61	$60.31	$121.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.07 / $138.59 / $211.07	Professional		$50.07	$138.59	$211.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.35 / $30.78 / $98.00	Professional	26	$16.35	$30.78	$98.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.80 / $27.80 / $27.80	Facility	26	$27.80	$27.80	$27.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.50 / $192.34 / $252.81	Professional		$119.50	$192.34	$252.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.75 / $40.46 / $67.58	Professional	26	$20.75	$40.46	$67.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.38 / $183.15 / $211.78	Professional		$154.38	$183.15	$211.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.82 / $55.94 / $62.99	Professional	26	$46.82	$55.94	$62.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $116.48 / $153.88 / $244.47	Professional		$116.48	$153.88	$244.47
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.65 / $48.69 / $77.44	Professional	26	$33.65	$48.69	$77.44
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $26.46 / $39.60 / $48.24	Facility	26	$26.46	$39.60	$48.24
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $298.17 / $298.17 / $298.17	Professional		$298.17	$298.17	$298.17
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $21.00 / $31.20 / $49.72	Professional	26	$21.00	$31.20	$49.72
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $27.80 / $27.80 / $27.80	Facility	26	$27.80	$27.80	$27.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.04 / $177.76 / $226.38	Professional		$123.04	$177.76	$226.38
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.37 / $45.10 / $70.51	Professional	26	$25.37	$45.10	$70.51
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,538.06 / $1,538.06 / $1,538.06	Facility	26	$1,538.06	$1,538.06	$1,538.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $138.25 / $183.82 / $218.87	Professional		$138.25	$183.82	$218.87
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $33.26 / $51.30 / $68.22	Professional	26	$33.26	$51.30	$68.22
United Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $150.13 / $283.52	Professional		$75.06	$150.13	$283.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.32 / $30.82 / $74.29	Professional	26	$18.32	$30.82	$74.29