Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $192.53 / $225.73 / $454.91	Facility	26	$192.53	$225.73	$454.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.75 / $150.00 / $265.00	Professional	26	$118.75	$150.00	$265.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.04 / $181.85 / $265.51	Professional	26	$93.04	$181.85	$265.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $89.43 / $206.22 / $213.33	Professional	26	$89.43	$206.22	$213.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $144.11 / $186.93 / $286.48	Professional	26	$144.11	$186.93	$286.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $136.71 / $178.16 / $187.99	Facility	26	$136.71	$178.16	$187.99
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $109.60 / $163.02 / $200.93	Professional	26	$109.60	$163.02	$200.93
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $99.27 / $178.86 / $265.51	Professional	26	$99.27	$178.86	$265.51
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 $169.47 / $213.63 / $254.88	Professional	26	$169.47	$213.63	$254.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.98 / $124.00 / $278.69	Professional	26	$80.98	$124.00	$278.69