Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.73 / $80.73 / $87.34	Facility	26	$80.73	$80.73	$87.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.53 / $81.26 / $273.00	Professional		$59.53	$81.26	$273.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.31 / $43.51 / $87.11	Professional	26	$33.31	$43.51	$87.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.06 / $133.81 / $204.54	Professional		$70.06	$133.81	$204.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.54 / $72.23 / $110.09	Professional	26	$41.54	$72.23	$110.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.16 / $155.06 / $186.02	Professional		$127.16	$155.06	$186.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.40 / $75.83 / $90.97	Professional	26	$64.40	$75.83	$90.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $115.94 / $181.66	Professional		$97.44	$115.94	$181.66
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.17 / $62.83 / $107.76	Professional	26	$45.17	$62.83	$107.76
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $52.81 / $69.59 / $73.03	Facility	26	$52.81	$69.59	$73.03
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $57.20 / $69.68 / $84.24	Professional		$57.20	$69.68	$84.24
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $45.76 / $57.20 / $75.20	Professional	26	$45.76	$57.20	$75.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.34 / $139.87 / $187.44	Professional		$92.34	$139.87	$187.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $44.45 / $70.12 / $95.28	Professional	26	$44.45	$70.12	$95.28
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $127.19 / $127.19 / $127.19	Facility	26	$127.19	$127.19	$127.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.58 / $142.18 / $189.27	Professional		$83.58	$142.18	$189.27
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $42.88 / $73.55 / $98.41	Professional	26	$42.88	$73.55	$98.41
United Facility/Professional Professional Modifier Low / Median / High Price $90.70 / $130.00 / $201.67	Professional		$90.70	$130.00	$201.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.87 / $74.80 / $111.72	Professional	26	$50.87	$74.80	$111.72