Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.45 / $204.51 / $454.36	Facility	26	$125.45	$204.51	$454.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.43 / $287.36 / $1,022.39	Professional		$173.43	$287.36	$1,022.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.76 / $103.69 / $352.18	Professional	26	$81.76	$103.69	$352.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.05 / $382.02 / $523.16	Professional		$204.05	$382.02	$523.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.45 / $188.71 / $271.18	Professional	26	$105.45	$188.71	$271.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $341.13 / $397.55 / $476.00	Professional		$341.13	$397.55	$476.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $169.58 / $200.39 / $231.56	Professional	26	$169.58	$200.39	$231.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $277.50 / $302.76 / $535.77	Professional		$277.50	$302.76	$535.77
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $142.51 / $174.47 / $283.29	Professional	26	$142.51	$174.47	$283.29
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $136.13 / $177.25 / $187.68	Facility	26	$136.13	$177.25	$187.68
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $125.94 / $125.94 / $125.94	Professional		$125.94	$125.94	$125.94
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $124.20 / $160.03 / $204.98	Professional	26	$124.20	$160.03	$204.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $305.61 / $385.01 / $516.04	Professional		$305.61	$385.01	$516.04
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $121.86 / $196.42 / $265.70	Professional	26	$121.86	$196.42	$265.70
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $385.75 / $385.75 / $385.75	Facility	26	$385.75	$385.75	$385.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $315.44 / $416.60 / $499.33	Professional		$315.44	$416.60	$499.33
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $164.15 / $215.93 / $256.95	Professional	26	$164.15	$215.93	$256.95
United Facility/Professional Professional Modifier Low / Median / High Price $180.81 / $206.09 / $517.83	Professional		$180.81	$206.09	$517.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.72 / $106.40 / $277.00	Professional	26	$96.72	$106.40	$277.00