Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.35 / $113.74 / $165.90	Facility	26	$106.35	$113.74	$165.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $157.65 / $174.87 / $341.65	Professional		$157.65	$174.87	$341.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.51 / $83.01 / $277.88	Professional	26	$64.51	$83.01	$277.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.49 / $309.75 / $427.62	Professional		$176.49	$309.75	$427.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.44 / $130.11 / $180.70	Professional	26	$74.44	$130.11	$180.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $280.97 / $330.55 / $393.12	Professional		$280.97	$330.55	$393.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $121.79 / $141.87 / $168.72	Professional	26	$121.79	$141.87	$168.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $200.47 / $276.00 / $380.42	Professional		$200.47	$276.00	$380.42
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.25 / $122.91 / $202.19	Professional	26	$92.25	$122.91	$202.19
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $96.04 / $131.32 / $133.33	Facility	26	$96.04	$131.32	$133.33
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $82.32 / $117.60 / $138.18	Professional	26	$82.32	$117.60	$138.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $214.46 / $324.89 / $419.52	Professional		$214.46	$324.89	$419.52
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $75.11 / $133.71 / $180.70	Professional	26	$75.11	$133.71	$180.70
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $838.61 / $838.61 / $838.61	Facility	26	$838.61	$838.61	$838.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $197.20 / $326.04 / $431.55	Professional		$197.20	$326.04	$431.55
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $84.58 / $142.57 / $188.55	Professional	26	$84.58	$142.57	$188.55
United Facility/Professional Professional Modifier Low / Median / High Price $216.00 / $315.70 / $460.79	Professional		$216.00	$315.70	$460.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.60 / $135.36 / $203.98	Professional	26	$93.60	$135.36	$203.98