Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $245.47 / $275.42	Facility	26	$147.91	$245.47	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $120.23 / $489.78	Professional	26	$91.20	$120.23	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $223.87 / $323.59	Professional	26	$147.91	$223.87	$323.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $239.88 / $281.84	Professional	26	$109.65	$239.88	$281.84
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $245.47 / $346.74	Professional	26	$173.78	$245.47	$346.74
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $213.80 / $223.87	Facility	26	$177.83	$213.80	$223.87
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $204.17 / $234.42	Professional	26	$138.04	$204.17	$234.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $229.09 / $316.23	Professional	26	$158.49	$229.09	$316.23
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $812.83 / $812.83 / $812.83	Facility	26	$812.83	$812.83	$812.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $229.09 / $295.12	Professional	26	$194.98	$229.09	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $117.49 / $331.13	Professional	26	$100.00	$117.49	$331.13