Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $198.96 / $227.26 / $457.58	Facility	26	$198.96	$227.26	$457.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.39 / $226.12 / $424.99	Professional		$124.39	$226.12	$424.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.66 / $92.00 / $232.44	Professional	26	$75.66	$92.00	$232.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.81 / $106.81 / $106.81	Facility	26	$106.81	$106.81	$106.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.73 / $331.93 / $525.01	Professional		$229.73	$331.93	$525.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.10 / $167.82 / $258.18	Professional	26	$99.10	$167.82	$258.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.95 / $360.85 / $410.37	Professional		$302.95	$360.85	$410.37
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $174.66 / $207.97 / $234.16	Professional	26	$174.66	$207.97	$234.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $249.78 / $326.27 / $496.53	Professional		$249.78	$326.27	$496.53
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $147.84 / $180.99 / $280.58	Professional	26	$147.84	$180.99	$280.58
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $122.99 / $172.50 / $185.59	Facility	26	$122.99	$172.50	$185.59
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $111.76 / $142.10 / $182.50	Professional	26	$111.76	$142.10	$182.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $106.81 / $106.81 / $106.81	Facility	26	$106.81	$106.81	$106.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $272.89 / $367.13 / $468.35	Professional		$272.89	$367.13	$468.35
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $120.58 / $178.38 / $260.94	Professional	26	$120.58	$178.38	$260.94
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $8,401.03 / $8,401.03 / $8,401.03	Facility	26	$8,401.03	$8,401.03	$8,401.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $280.70 / $347.25 / $444.38	Professional		$280.70	$347.25	$444.38
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $153.75 / $191.82 / $261.51	Professional	26	$153.75	$191.82	$261.51
United Facility/Professional Professional Modifier Low / Median / High Price $173.59 / $201.75 / $498.97	Professional		$173.59	$201.75	$498.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.12 / $115.79 / $286.31	Professional	26	$89.12	$115.79	$286.31