Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $64.57 / $151.36	Facility	26	$46.77	$64.57	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $125.89 / $263.03	Professional	26	$38.02	$125.89	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $42.66 / $85.11	Professional	26	$28.84	$42.66	$85.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $61.66 / $69.18	Professional	26	$29.51	$61.66	$69.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $69.18 / $125.89	Professional	26	$47.86	$69.18	$125.89
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $57.54 / $58.88	Facility	26	$46.77	$57.54	$58.88
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $46.77 / $57.54	Professional	26	$33.88	$46.77	$57.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $53.70 / $83.18	Professional	26	$28.84	$53.70	$83.18
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $61.66 / $72.44	Professional	26	$53.70	$61.66	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $28.84 / $89.13	Professional	26	$26.92	$28.84	$89.13