Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $229.09 / $562.34	Facility	26	$147.91	$229.09	$562.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $323.59 / $1,096.48	Professional		$165.96	$323.59	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $125.89 / $389.05	Professional	26	$75.86	$125.89	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $501.19	Professional		$194.98	$346.74	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $169.82 / $263.03	Professional	26	$95.50	$169.82	$263.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $380.19 / $467.74	Professional		$309.03	$380.19	$467.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $190.55 / $229.09	Professional	26	$147.91	$190.55	$229.09
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $251.19 / $562.34	Facility	26	$181.97	$251.19	$562.34
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $346.74 / $524.81	Professional		$229.09	$346.74	$524.81
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $186.21 / $269.15	Professional	26	$107.15	$186.21	$269.15
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $177.83 / $186.21	Facility	26	$147.91	$177.83	$186.21
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $158.49	Professional		$125.89	$125.89	$158.49
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $158.49 / $213.80	Professional	26	$109.65	$158.49	$213.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $363.08 / $501.19	Professional		$281.84	$363.08	$501.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $186.21 / $251.19	Professional	26	$123.03	$186.21	$251.19
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	26	$389.05	$389.05	$389.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $478.63	Professional		$316.23	$371.54	$478.63
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $194.98 / $257.04	Professional	26	$165.96	$194.98	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $467.74	Professional		$181.97	$213.80	$467.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $104.71 / $251.19	Professional	26	$93.33	$104.71	$251.19