Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $57.54 / $61.66	Facility	26	$39.81	$57.54	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $107.15 / $223.87	Professional		$50.12	$107.15	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $33.11 / $95.50	Professional	26	$16.60	$33.11	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $275.42	Professional		$104.71	$165.96	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $40.74 / $70.79	Professional	26	$19.95	$40.74	$70.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $173.78 / $213.80	Professional		$158.49	$173.78	$213.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $53.70 / $63.10	Professional	26	$46.77	$53.70	$63.10
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $61.66 / $61.66	Facility	26	$57.54	$61.66	$61.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $239.88	Professional		$107.15	$165.96	$239.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $48.98 / $72.44	Professional	26	$23.44	$48.98	$72.44
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $39.81 / $47.86	Facility	26	$28.18	$39.81	$47.86
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $380.19 / $380.19	Professional		$363.08	$380.19	$380.19
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.90 / $47.86	Professional	26	$20.89	$30.90	$47.86
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	26	$6.03	$28.18	$39.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $165.96 / $239.88	Professional		$123.03	$165.96	$239.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $41.69 / $70.79	Professional	26	$28.18	$41.69	$70.79
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Facility	26	$1,548.82	$1,548.82	$1,548.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $165.96 / $234.42	Professional		$138.04	$165.96	$234.42
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $50.12 / $64.57	Professional	26	$33.11	$50.12	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $138.04 / $281.84	Professional		$75.86	$138.04	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $26.92 / $63.10	Professional	26	$17.78	$26.92	$63.10