Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $141.25 / $162.18	Facility	26	$89.13	$141.25	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $407.38 / $831.76	Professional		$295.12	$407.38	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $67.61 / $154.88	Professional	26	$50.12	$67.61	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $870.96 / $1,071.52	Professional		$575.44	$870.96	$1,071.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $154.88 / $190.55	Professional	26	$104.71	$154.88	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $707.95 / $831.76	Professional		$354.81	$707.95	$831.76
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $138.04 / $151.36	Professional	26	$64.57	$138.04	$151.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $660.69 / $1,047.13	Professional		$537.03	$660.69	$1,047.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $144.54 / $204.17	Professional	26	$100.00	$144.54	$204.17
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $125.89 / $131.83	Facility	26	$104.71	$125.89	$131.83
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $117.49 / $138.04	Professional	26	$77.62	$117.49	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $724.44 / $977.24	Professional		$512.86	$724.44	$977.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $131.83 / $186.21	Professional	26	$91.20	$131.83	$186.21
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility	26	$1,513.56	$1,513.56	$1,513.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $741.31 / $870.96	Professional		$645.65	$741.31	$870.96
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $138.04 / $165.96	Professional	26	$117.49	$138.04	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $1,096.48	Professional		$323.59	$323.59	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $64.57 / $199.53	Professional	26	$58.88	$64.57	$199.53