Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $151.36 / $169.82	Facility	26	$85.11	$151.36	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $338.84	Professional		$141.25	$177.83	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $85.11 / $288.40	Professional	26	$64.57	$85.11	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $288.40 / $426.58	Professional		$173.78	$288.40	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $123.03 / $173.78	Professional	26	$70.79	$123.03	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $354.81 / $426.58	Professional		$269.15	$354.81	$426.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $144.54 / $173.78	Professional	26	$109.65	$144.54	$173.78
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $114.82 / $114.82	Facility	26	$107.15	$114.82	$114.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $288.40 / $389.05	Professional		$208.93	$288.40	$389.05
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $128.82 / $177.83	Professional	26	$79.43	$128.82	$177.83
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $131.83 / $131.83	Facility	26	$109.65	$131.83	$131.83
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $114.82 / $141.25	Professional	26	$79.43	$114.82	$141.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $323.59 / $426.58	Professional		$213.80	$323.59	$426.58
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $128.82 / $173.78	Professional	26	$81.28	$128.82	$173.78
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $831.76 / $831.76 / $831.76	Facility	26	$831.76	$831.76	$831.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $316.23 / $416.87	Professional		$239.88	$316.23	$416.87
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $138.04 / $177.83	Professional	26	$104.71	$138.04	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $302.00 / $436.52	Professional		$190.55	$302.00	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $131.83 / $190.55	Professional	26	$83.18	$131.83	$190.55