Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.53 / $123.60 / $242.50	Facility	26	$106.53	$123.60	$242.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.77 / $131.93 / $287.16	Professional		$85.77	$131.93	$287.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.37 / $44.23 / $109.75	Professional	26	$31.37	$44.23	$109.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.06 / $56.06 / $56.06	Facility	26	$56.06	$56.06	$56.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.85 / $222.56 / $317.83	Professional		$120.85	$222.56	$317.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.11 / $79.43 / $136.03	Professional	26	$39.11	$79.43	$136.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $209.22 / $247.33 / $283.85	Professional		$209.22	$247.33	$283.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.69 / $109.26 / $123.01	Professional	26	$91.69	$109.26	$123.01
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.72 / $192.34 / $332.43	Professional		$169.72	$192.34	$332.43
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.34 / $94.09 / $148.44	Professional	26	$65.34	$94.09	$148.44
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $50.20 / $79.12 / $97.15	Facility	26	$50.20	$79.12	$97.15
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $42.57 / $61.20 / $79.75	Professional	26	$42.57	$61.20	$79.75
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $56.06 / $56.06 / $56.06	Facility	26	$56.06	$56.06	$56.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $181.96 / $239.61 / $320.10	Professional		$181.96	$239.61	$320.10
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $49.72 / $85.05 / $138.91	Professional	26	$49.72	$85.05	$138.91
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,064.48 / $2,064.48 / $2,064.48	Facility	26	$2,064.48	$2,064.48	$2,064.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $195.71 / $232.47 / $309.83	Professional		$195.71	$232.47	$309.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $62.72 / $97.59 / $138.34	Professional	26	$62.72	$97.59	$138.34
United Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $129.02 / $314.20	Professional		$109.71	$129.02	$314.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.11 / $49.48 / $126.42	Professional	26	$35.11	$49.48	$126.42