Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $50.12 / $54.95	Facility	26	$28.84	$50.12	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $54.95 / $128.82	Professional		$33.88	$54.95	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.99 / $54.95	Professional	26	$19.95	$23.99	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $95.50 / $154.88	Professional		$43.65	$95.50	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $40.74 / $63.10	Professional	26	$23.99	$40.74	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $109.65 / $138.04	Professional		$91.20	$109.65	$138.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $46.77 / $54.95	Professional	26	$37.15	$46.77	$54.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $83.18 / $128.82	Professional		$57.54	$83.18	$128.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $42.66 / $57.54	Professional	26	$27.54	$42.66	$57.54
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $42.66 / $44.67	Facility	26	$34.67	$42.66	$44.67
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $36.31 / $44.67	Professional	26	$25.70	$36.31	$44.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $102.33 / $144.54	Professional		$53.70	$102.33	$144.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $40.74 / $57.54	Professional	26	$26.92	$40.74	$57.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $104.71 / $138.04	Professional		$64.57	$104.71	$138.04
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $44.67 / $56.23	Professional	26	$27.54	$44.67	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $91.20 / $138.04	Professional		$52.48	$91.20	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $45.71 / $63.10	Professional	26	$27.54	$45.71	$63.10