Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $131.83 / $245.47	Professional		$95.50	$131.83	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.99 / $50.12	Professional	26	$19.95	$23.99	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $120.23 / $234.42	Professional		$50.12	$120.23	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $22.39 / $44.67	Professional	26	$12.88	$22.39	$44.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $263.03 / $380.19	Professional		$131.83	$263.03	$380.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $50.12 / $72.44	Professional	26	$25.12	$50.12	$72.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $239.88 / $426.58	Professional		$147.91	$239.88	$426.58
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $46.77 / $85.11	Professional	26	$38.02	$46.77	$85.11
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $51.29 / $52.48	Facility	26	$42.66	$51.29	$52.48
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $40.74 / $63.10	Professional	26	$32.36	$40.74	$63.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $208.93 / $426.58	Professional		$97.72	$208.93	$426.58
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $27.54 / $75.86	Professional	26	$15.85	$27.54	$75.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $257.04 / $426.58	Professional		$162.18	$257.04	$426.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $52.48 / $83.18	Professional	26	$30.90	$52.48	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $114.82 / $426.58	Professional		$67.61	$114.82	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $27.54 / $81.28	Professional	26	$16.98	$27.54	$81.28