Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.33 / $171.55 / $383.67	Facility	26	$162.33	$171.55	$383.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.55 / $189.07 / $472.10	Professional		$155.55	$189.07	$472.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.59 / $78.43 / $199.54	Professional	26	$67.59	$78.43	$199.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.97 / $356.72 / $507.23	Professional		$186.97	$356.72	$507.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.81 / $159.19 / $222.24	Professional	26	$84.81	$159.19	$222.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $335.69 / $391.20 / $471.22	Professional		$335.69	$391.20	$471.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $144.13 / $169.90 / $196.82	Professional	26	$144.13	$169.90	$196.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $257.50 / $296.63 / $531.69	Professional		$257.50	$296.63	$531.69
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $121.16 / $146.72 / $240.85	Professional	26	$121.16	$146.72	$240.85
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $108.29 / $148.74 / $151.41	Facility	26	$108.29	$148.74	$151.41
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $86.94 / $86.94 / $86.94	Professional		$86.94	$86.94	$86.94
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $89.24 / $130.07 / $154.40	Professional	26	$89.24	$130.07	$154.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $286.14 / $373.95 / $502.46	Professional		$286.14	$373.95	$502.46
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $101.02 / $163.40 / $221.20	Professional	26	$101.02	$163.40	$221.20
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 $313.02 / $413.27 / $495.54	Professional		$313.02	$413.27	$495.54
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $136.03 / $179.00 / $214.14	Professional	26	$136.03	$179.00	$214.14
United Facility/Professional Professional Modifier Low / Median / High Price $168.53 / $214.80 / $580.53	Professional		$168.53	$214.80	$580.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.69 / $86.58 / $229.46	Professional	26	$78.69	$86.58	$229.46