Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $179.68 / $207.95 / $419.91	Facility	26	$179.68	$207.95	$419.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.63 / $150.00 / $265.00	Professional	26	$93.63	$150.00	$265.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.09 / $169.46 / $243.88	Professional	26	$86.09	$169.46	$243.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $82.21 / $189.57 / $196.11	Professional	26	$82.21	$189.57	$196.11
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.84 / $186.06 / $262.07	Professional	26	$131.84	$186.06	$262.07
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $124.46 / $163.71 / $182.56	Facility	26	$124.46	$163.71	$182.56
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $104.92 / $154.80 / $184.06	Professional	26	$104.92	$154.80	$184.06
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $93.21 / $166.67 / $243.88	Professional	26	$93.21	$166.67	$243.88
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $4,641.51 / $4,641.51 / $4,641.51	Facility	26	$4,641.51	$4,641.51	$4,641.51
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $156.24 / $200.28 / $234.98	Professional	26	$156.24	$200.28	$234.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.45 / $124.73 / $263.85	Professional	26	$75.45	$124.73	$263.85