Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $184.50 / $342.59	Facility	26	$147.91	$184.50	$342.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $150.00 / $350.00	Professional	26	$90.00	$150.00	$350.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.61 / $135.31 / $199.13	Professional	26	$70.61	$135.31	$199.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.75 / $156.22 / $161.61	Professional	26	$67.75	$156.22	$161.61
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $108.88 / $137.35 / $216.45	Professional	26	$108.88	$137.35	$216.45
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $98.84 / $135.02 / $138.86	Facility	26	$98.84	$135.02	$138.86
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $85.68 / $127.04 / $159.36	Professional	26	$85.68	$127.04	$159.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $74.43 / $133.08 / $199.13	Professional	26	$74.43	$133.08	$199.13
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 $126.27 / $160.22 / $193.29	Professional	26	$126.27	$160.22	$193.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.27 / $81.08 / $217.04	Professional	26	$62.27	$81.08	$217.04