Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $150.05 / $174.96 / $353.48	Facility	26	$150.05	$174.96	$353.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $603.00 / $1,163.96	Professional		$475.00	$603.00	$1,163.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.00 / $140.00 / $189.00	Professional	26	$104.00	$140.00	$189.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $577.13 / $1,043.58 / $1,339.18	Professional		$577.13	$1,043.58	$1,339.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.54 / $161.44 / $205.53	Professional	26	$105.54	$161.44	$205.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $693.12 / $980.68 / $1,140.98	Professional		$693.12	$980.68	$1,140.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $114.09 / $161.16 / $181.45	Professional	26	$114.09	$161.16	$181.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $586.50 / $705.88 / $1,323.02	Professional		$586.50	$705.88	$1,323.02
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.08 / $148.09 / $222.81	Professional	26	$112.08	$148.09	$222.81
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $104.86 / $138.99 / $142.04	Facility	26	$104.86	$138.99	$142.04
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $86.92 / $122.55 / $148.50	Professional	26	$86.92	$122.55	$148.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $693.50 / $1,016.30 / $1,254.79	Professional		$693.50	$1,016.30	$1,254.79
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $110.64 / $162.76 / $205.53	Professional	26	$110.64	$162.76	$205.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $769.67 / $1,046.96 / $1,362.77	Professional		$769.67	$1,046.96	$1,362.77
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $125.09 / $171.48 / $223.21	Professional	26	$125.09	$171.48	$223.21
United Facility/Professional Professional Modifier Low / Median / High Price $352.78 / $419.39 / $1,368.18	Professional		$352.78	$419.39	$1,368.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.50 / $97.12 / $220.28	Professional	26	$63.50	$97.12	$220.28