Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $141.25 / $173.78	Facility	26	$89.13	$141.25	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $213.80	Professional		$75.86	$114.82	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $74.13 / $234.42	Professional	26	$56.23	$74.13	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $213.80 / $275.42	Professional		$114.82	$213.80	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $151.36 / $194.98	Professional	26	$79.43	$151.36	$194.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $251.19	Professional		$158.49	$204.17	$251.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $144.54 / $173.78	Professional	26	$112.20	$144.54	$173.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $186.21 / $346.74	Professional		$128.82	$186.21	$346.74
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $128.82 / $213.80	Professional	26	$87.10	$128.82	$213.80
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $128.82 / $134.90	Facility	26	$107.15	$128.82	$134.90
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $114.82 / $134.90	Professional	26	$77.62	$114.82	$134.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $204.17 / $257.04	Professional		$147.91	$204.17	$257.04
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $141.25 / $186.21	Professional	26	$91.20	$141.25	$186.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $190.55 / $257.04	Professional		$165.96	$190.55	$257.04
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $134.90 / $181.97	Professional	26	$123.03	$134.90	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $95.50 / $251.19	Professional		$91.20	$95.50	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $69.18 / $177.83	Professional	26	$67.61	$69.18	$177.83