Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $311.10 / $420.00 / $1,012.27	Facility	26	$311.10	$420.00	$1,012.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $546.25 / $653.45 / $1,569.88	Professional		$546.25	$653.45	$1,569.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $174.37 / $194.67 / $497.00	Professional	26	$174.37	$194.67	$497.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $896.77 / $1,345.23 / $1,692.43	Professional		$896.77	$1,345.23	$1,692.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $285.57 / $425.55 / $549.55	Professional	26	$285.57	$425.55	$549.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,227.84 / $1,437.77 / $1,663.14	Professional		$1,227.84	$1,437.77	$1,663.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $388.41 / $465.90 / $526.11	Professional	26	$388.41	$465.90	$526.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $950.32 / $1,075.52 / $1,949.01	Professional		$950.32	$1,075.52	$1,949.01
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $322.91 / $459.90 / $641.90	Professional	26	$322.91	$459.90	$641.90
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $270.35 / $373.86 / $397.98	Facility	26	$270.35	$373.86	$397.98
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $228.78 / $326.70 / $397.98	Professional	26	$228.78	$326.70	$397.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $994.74 / $1,385.49 / $1,778.12	Professional		$994.74	$1,385.49	$1,778.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $262.74 / $420.14 / $549.55	Professional	26	$262.74	$420.14	$549.55
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,406.69 / $2,406.69 / $2,406.69	Facility	26	$2,406.69	$2,406.69	$2,406.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,079.04 / $1,403.92 / $1,702.66	Professional		$1,079.04	$1,403.92	$1,702.66
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $356.11 / $462.18 / $563.76	Professional	26	$356.11	$462.18	$563.76
United Facility/Professional Professional Modifier Low / Median / High Price $754.96 / $809.28 / $1,911.82	Professional		$754.96	$809.28	$1,911.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $249.29 / $261.66 / $633.03	Professional	26	$249.29	$261.66	$633.03