Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.80 / $92.69 / $187.16	Facility	26	$80.80	$92.69	$187.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.65 / $277.29 / $1,427.00	Professional		$166.65	$277.29	$1,427.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.96 / $51.47 / $189.00	Professional	26	$34.96	$51.47	$189.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $482.33 / $652.66 / $858.27	Professional		$482.33	$652.66	$858.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.20 / $84.09 / $106.93	Professional	26	$60.20	$84.09	$106.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $279.88 / $624.29 / $667.63	Professional		$279.88	$624.29	$667.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.09 / $85.53 / $88.48	Professional	26	$37.09	$85.53	$88.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $298.14 / $474.88 / $832.62	Professional		$298.14	$474.88	$832.62
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.78 / $76.38 / $118.83	Professional	26	$59.78	$76.38	$118.83
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $54.26 / $73.70 / $75.48	Facility	26	$54.26	$73.70	$75.48
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $273.14 / $273.14 / $273.14	Professional		$273.14	$273.14	$273.14
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $45.02 / $64.98 / $83.07	Professional	26	$45.02	$64.98	$83.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $355.50 / $646.62 / $756.46	Professional		$355.50	$646.62	$756.46
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.79 / $75.38 / $106.93	Professional	26	$58.79	$75.38	$106.93
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,177.68 / $1,177.68 / $1,177.68	Facility	26	$1,177.68	$1,177.68	$1,177.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $515.97 / $662.96 / $776.00	Professional		$515.97	$662.96	$776.00
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $67.09 / $87.18 / $105.17	Professional	26	$67.09	$87.18	$105.17
United Facility/Professional Professional Modifier Low / Median / High Price $260.13 / $266.33 / $871.35	Professional		$260.13	$266.33	$871.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.75 / $44.34 / $114.99	Professional	26	$33.75	$44.34	$114.99