Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $208.93 / $234.42	Facility	26	$151.36	$208.93	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $208.93 / $407.38	Professional		$123.03	$208.93	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $95.50 / $295.12	Professional	26	$52.48	$95.50	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $331.13 / $562.34	Professional		$199.53	$331.13	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $151.36 / $263.03	Professional	26	$63.10	$151.36	$263.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $363.08 / $457.09	Professional		$323.59	$363.08	$457.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $199.53 / $239.88	Professional	26	$169.82	$199.53	$239.88
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $234.42 / $234.42	Facility	26	$234.42	$234.42	$234.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $346.74 / $645.65	Professional		$234.42	$346.74	$645.65
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $181.97 / $275.42	Professional	26	$89.13	$181.97	$275.42
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $151.36 / $186.21	Facility	26	$89.13	$151.36	$186.21
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $102.33 / $181.97	Professional	26	$66.07	$102.33	$181.97
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $107.15 / $154.88	Facility	26	$22.91	$107.15	$154.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $363.08 / $489.78	Professional		$269.15	$363.08	$489.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $263.03	Professional	26	$85.11	$141.25	$263.03
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $14,454.40 / $14,454.40 / $14,454.40	Facility	26	$14,454.40	$14,454.40	$14,454.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $338.84 / $457.09	Professional		$288.40	$338.84	$457.09
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $177.83 / $251.19	Professional	26	$102.33	$177.83	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $309.03 / $537.03	Professional		$165.96	$309.03	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $100.00 / $245.47	Professional	26	$56.23	$100.00	$245.47