Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.14 / $121.14 / $133.34	Facility	26	$121.14	$121.14	$133.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.96 / $289.14 / $638.39	Professional		$197.96	$289.14	$638.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.45 / $63.92 / $148.61	Professional	26	$41.45	$63.92	$148.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.41 / $60.41 / $60.41	Facility	26	$60.41	$60.41	$60.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.99 / $459.51 / $828.99	Professional		$271.99	$459.51	$828.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.77 / $103.89 / $152.19	Professional	26	$60.77	$103.89	$152.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $642.09 / $765.36 / $891.79	Professional		$642.09	$765.36	$891.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $103.35 / $123.57 / $139.99	Professional	26	$103.35	$123.57	$139.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $416.02 / $565.94 / $848.91	Professional		$416.02	$565.94	$848.91
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.39 / $112.82 / $162.66	Professional	26	$85.39	$112.82	$162.66
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $80.08 / $105.19 / $106.53	Facility	26	$80.08	$105.19	$106.53
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $63.54 / $87.45 / $106.53	Professional	26	$63.54	$87.45	$106.53
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $60.41 / $60.41 / $60.41	Facility	26	$60.41	$60.41	$60.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $403.51 / $563.55 / $736.16	Professional		$403.51	$563.55	$736.16
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $71.56 / $108.44 / $152.19	Professional	26	$71.56	$108.44	$152.19
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $838.61 / $838.61 / $838.61	Facility	26	$838.61	$838.61	$838.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $395.16 / $571.59 / $731.47	Professional		$395.16	$571.59	$731.47
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $86.40 / $118.46 / $151.60	Professional	26	$86.40	$118.46	$151.60
United Facility/Professional Professional Modifier Low / Median / High Price $242.16 / $436.15 / $734.92	Professional		$242.16	$436.15	$734.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.58 / $103.94 / $157.69	Professional	26	$55.58	$103.94	$157.69