Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.56 / $132.93 / $263.83	Professional		$62.56	$132.93	$263.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.01 / $24.28 / $50.25	Professional	26	$20.01	$24.28	$50.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.10 / $93.82 / $235.31	Professional		$50.10	$93.82	$235.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.83 / $28.66 / $44.86	Professional	26	$12.83	$28.66	$44.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.40 / $268.02 / $382.04	Professional		$129.40	$268.02	$382.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.01 / $51.80 / $73.84	Professional	26	$25.01	$51.80	$73.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $140.79 / $237.71 / $430.76	Professional		$140.79	$237.71	$430.76
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.63 / $46.90 / $82.75	Professional	26	$41.63	$46.90	$82.75
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $32.76 / $51.80 / $52.26	Facility	26	$32.76	$51.80	$52.26
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $36.65 / $45.03 / $58.11	Professional	26	$36.65	$45.03	$58.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $133.68 / $259.95 / $395.92	Professional		$133.68	$259.95	$395.92
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $28.66 / $45.04	Professional	26	$15.96	$28.66	$45.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $241.79 / $254.52 / $437.88	Professional		$241.79	$254.52	$437.88
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $46.68 / $53.17 / $83.30	Professional	26	$46.68	$53.17	$83.30
United Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $113.68 / $425.80	Professional		$68.20	$113.68	$425.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $27.76 / $82.21	Professional	26	$16.89	$27.76	$82.21