Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.40 / $249.95 / $503.96	Facility	26	$218.40	$249.95	$503.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.63 / $155.69 / $266.14	Professional	26	$93.63	$155.69	$266.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.76 / $202.33 / $294.02	Professional	26	$104.76	$202.33	$294.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $99.64 / $229.76 / $237.68	Professional	26	$99.64	$229.76	$237.68
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $160.63 / $204.35 / $319.33	Professional	26	$160.63	$204.35	$319.33
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $150.91 / $198.61 / $207.03	Facility	26	$150.91	$198.61	$207.03
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $123.60 / $181.50 / $228.75	Professional	26	$123.60	$181.50	$228.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $110.15 / $198.99 / $294.02	Professional	26	$110.15	$198.99	$294.02
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 $190.89 / $237.19 / $287.08	Professional	26	$190.89	$237.19	$287.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.34 / $97.44 / $322.37	Professional	26	$92.34	$97.44	$322.37