Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $234.29 / $267.44 / $538.21	Facility	26	$234.29	$267.44	$538.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.36 / $148.82 / $297.04	Professional	26	$73.36	$148.82	$297.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $164.55 / $225.07 / $316.87	Professional	26	$164.55	$225.07	$316.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $205.44 / $248.84 / $278.27	Professional	26	$205.44	$248.84	$278.27
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $173.99 / $243.08 / $345.88	Professional	26	$173.99	$243.08	$345.88
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $160.72 / $213.94 / $222.44	Facility	26	$160.72	$213.94	$222.44
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $141.04 / $198.85 / $244.50	Professional	26	$141.04	$198.85	$244.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $144.96 / $225.07 / $316.87	Professional	26	$144.96	$225.07	$316.87
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $803.73 / $803.73 / $803.73	Facility	26	$803.73	$803.73	$803.73
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $202.52 / $256.86 / $306.99	Professional	26	$202.52	$256.86	$306.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.39 / $124.88 / $344.69	Professional	26	$99.39	$124.88	$344.69