Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $190.55 / $218.78	Facility	26	$141.25	$190.55	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $151.36 / $263.03	Professional	26	$93.33	$151.36	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $128.82 / $251.19	Professional	26	$87.10	$128.82	$251.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $186.21 / $208.93	Professional	26	$89.13	$186.21	$208.93
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $204.17 / $288.40	Professional	26	$141.25	$204.17	$288.40
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $169.82 / $173.78	Facility	26	$141.25	$169.82	$173.78
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $141.25 / $173.78	Professional	26	$102.33	$141.25	$173.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $158.49 / $251.19	Professional	26	$87.10	$158.49	$251.19
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $7,585.78 / $7,585.78 / $7,585.78	Facility	26	$7,585.78	$7,585.78	$7,585.78
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $186.21 / $223.87	Professional	26	$158.49	$186.21	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $87.10 / $269.15	Professional	26	$79.43	$87.10	$269.15