Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $81.28 / $95.50	Facility	26	$51.29	$81.28	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $281.84 / $676.08	Professional		$181.97	$281.84	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.69 / $169.82	Professional	26	$30.90	$41.69	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $691.83 / $851.14	Professional		$457.09	$691.83	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $89.13 / $109.65	Professional	26	$60.26	$89.13	$109.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $562.34 / $660.69	Professional		$288.40	$562.34	$660.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $79.43 / $89.13	Professional	26	$37.15	$79.43	$89.13
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $75.86	Facility	26	$51.29	$51.29	$75.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $537.03 / $851.14	Professional		$257.04	$537.03	$851.14
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $85.11 / $123.03	Professional	26	$53.70	$85.11	$123.03
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $74.13 / $75.86	Facility	26	$61.66	$74.13	$75.86
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Professional		$371.54	$371.54	$371.54
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $69.18 / $83.18	Professional	26	$44.67	$69.18	$83.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $588.84 / $776.25	Professional		$316.23	$588.84	$776.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $75.86 / $107.15	Professional	26	$53.70	$75.86	$107.15
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility	26	$1,174.90	$1,174.90	$1,174.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $588.84 / $691.83	Professional		$512.86	$588.84	$691.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $77.62 / $95.50	Professional	26	$67.61	$77.62	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $269.15 / $870.96	Professional		$239.88	$269.15	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $38.02 / $112.20	Professional	26	$33.88	$38.02	$112.20