Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $151.36 / $173.78	Facility	26	$112.20	$151.36	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $134.90 / $288.40	Professional	26	$75.86	$134.90	$288.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $102.33 / $199.53	Professional	26	$67.61	$102.33	$199.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $144.54 / $162.18	Professional	26	$69.18	$144.54	$162.18
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $186.21 / $186.21 / $186.21	Facility	26	$186.21	$186.21	$186.21
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $158.49 / $223.87	Professional	26	$109.65	$158.49	$223.87
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $134.90 / $138.04	Facility	26	$112.20	$134.90	$138.04
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $125.89 / $151.36	Professional	26	$77.62	$125.89	$151.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $138.04 / $190.55	Professional	26	$67.61	$138.04	$190.55
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $4,677.35 / $4,677.35 / $4,677.35	Facility	26	$4,677.35	$4,677.35	$4,677.35
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $144.54 / $173.78	Professional	26	$125.89	$144.54	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $66.07 / $208.93	Professional	26	$61.66	$66.07	$208.93