Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $162.18 / $194.98	Facility	26	$102.33	$162.18	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $190.55 / $478.63	Professional		$138.04	$190.55	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $79.43 / $331.13	Professional	26	$61.66	$79.43	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $331.13 / $489.78	Professional		$173.78	$331.13	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $141.25 / $213.80	Professional	26	$79.43	$141.25	$213.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $371.54 / $467.74	Professional		$302.00	$371.54	$467.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $162.18 / $190.55	Professional	26	$125.89	$162.18	$190.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $331.13 / $501.19	Professional		$245.47	$331.13	$501.19
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $154.88 / $223.87	Professional	26	$102.33	$154.88	$223.87
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $147.91 / $151.36	Facility	26	$112.20	$147.91	$151.36
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $131.83 / $165.96	Professional	26	$89.13	$131.83	$165.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $489.78	Professional		$275.42	$346.74	$489.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $154.88 / $213.80	Professional	26	$102.33	$154.88	$213.80
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 $309.03 / $371.54 / $467.74	Professional		$309.03	$371.54	$467.74
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $158.49 / $204.17	Professional	26	$134.90	$158.49	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $194.98 / $457.09	Professional		$169.82	$194.98	$457.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $85.11 / $199.53	Professional	26	$75.86	$85.11	$199.53