Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $184.50 / $256.75 / $566.78	Facility	26	$184.50	$256.75	$566.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.73 / $265.00 / $360.33	Professional	26	$111.73	$265.00	$360.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $116.94 / $226.84 / $330.42	Professional	26	$116.94	$226.84	$330.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $112.33 / $259.02 / $267.95	Professional	26	$112.33	$259.02	$267.95
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $180.92 / $231.82 / $359.65	Professional	26	$180.92	$231.82	$359.65
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $168.07 / $224.00 / $233.18	Facility	26	$168.07	$224.00	$233.18
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $144.47 / $199.33 / $256.29	Professional	26	$144.47	$199.33	$256.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $124.77 / $223.10 / $330.42	Professional	26	$124.77	$223.10	$330.42
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 $212.94 / $268.61 / $320.26	Professional	26	$212.94	$268.61	$320.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.30 / $157.44 / $375.18	Professional	26	$104.30	$157.44	$375.18