Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.54 / $36.54 / $53.01	Facility	26	$36.54	$36.54	$53.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.92 / $77.65 / $109.19	Professional		$66.92	$77.65	$109.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.61 / $23.50 / $32.64	Professional	26	$20.61	$23.50	$32.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.76 / $143.01 / $199.36	Professional		$81.76	$143.01	$199.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.77 / $44.07 / $61.95	Professional	26	$24.77	$44.07	$61.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.39 / $139.47 / $170.00	Professional		$125.39	$139.47	$170.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.65 / $45.10 / $53.64	Professional	26	$38.65	$45.10	$53.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $88.75 / $121.73 / $196.24	Professional		$88.75	$121.73	$196.24
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.53 / $38.72 / $66.84	Professional	26	$28.53	$38.72	$66.84
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $27.71 / $41.85 / $42.21	Facility	26	$27.71	$41.85	$42.21
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $25.11 / $31.66 / $42.21	Professional	26	$25.11	$31.66	$42.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.31 / $149.10 / $195.65	Professional		$103.31	$149.10	$195.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.07 / $44.70 / $61.95	Professional	26	$26.07	$44.70	$61.95
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $187.59 / $187.59 / $187.59	Facility	26	$187.59	$187.59	$187.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $92.73 / $151.96 / $207.43	Professional		$92.73	$151.96	$207.43
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.84 / $46.58 / $62.54	Professional	26	$26.84	$46.58	$62.54
United Facility/Professional Professional Modifier Low / Median / High Price $103.68 / $147.30 / $221.39	Professional		$103.68	$147.30	$221.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.15 / $45.69 / $68.39	Professional	26	$32.15	$45.69	$68.39