Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.26 / $207.88 / $237.33	Facility	26	$172.26	$207.88	$237.33
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $106.35 / $106.35 / $118.09	Facility	53	$106.35	$106.35	$118.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.99 / $337.47 / $604.49	Professional		$258.99	$337.47	$604.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.63 / $128.24 / $528.08	Professional	26	$95.63	$128.24	$528.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $320.45 / $525.07 / $774.99	Professional		$320.45	$525.07	$774.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.50 / $222.10 / $319.98	Professional	26	$131.50	$222.10	$319.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $446.57 / $520.41 / $624.76	Professional		$446.57	$520.41	$624.76
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $197.13 / $233.64 / $269.18	Professional	26	$197.13	$233.64	$269.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $372.01 / $473.96 / $717.72	Professional		$372.01	$473.96	$717.72
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $166.52 / $208.56 / $331.02	Professional	26	$166.52	$208.56	$331.02
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $158.76 / $206.66 / $210.91	Facility	26	$158.76	$206.66	$210.91
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $120.60 / $177.27 / $230.48	Professional	26	$120.60	$177.27	$230.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $437.72 / $559.51 / $695.25	Professional		$437.72	$559.51	$695.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $142.24 / $227.10 / $299.92	Professional	26	$142.24	$227.10	$299.92
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,640.24 / $1,640.24 / $1,640.24	Facility	26	$1,640.24	$1,640.24	$1,640.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $447.02 / $571.22 / $668.94	Professional		$447.02	$571.22	$668.94
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $192.40 / $242.74 / $295.62	Professional	26	$192.40	$242.74	$295.62
United Facility/Professional Professional Modifier Low / Median / High Price $305.91 / $529.65 / $731.40	Professional		$305.91	$529.65	$731.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $118.23 / $218.40 / $323.24	Professional	26	$118.23	$218.40	$323.24