Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.29 / $43.37 / $47.86	Facility	26	$32.29	$43.37	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.51 / $87.94 / $276.00	Professional		$56.51	$87.94	$276.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.07 / $22.14 / $53.05	Professional	26	$18.07	$22.14	$53.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $143.65 / $222.64	Professional		$78.45	$143.65	$222.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.54 / $37.81 / $56.05	Professional	26	$23.54	$37.81	$56.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.94 / $167.24 / $200.64	Professional		$138.94	$167.24	$200.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.34 / $41.98 / $49.67	Professional	26	$35.34	$41.98	$49.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $96.86 / $128.09 / $198.83	Professional		$96.86	$128.09	$198.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.43 / $35.64 / $60.48	Professional	26	$30.43	$35.64	$60.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $27.62 / $37.52 / $38.19	Facility	26	$27.62	$37.52	$38.19
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $32.46 / $38.19	Professional	26	$22.91	$32.46	$38.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $118.11 / $158.47 / $218.09	Professional		$118.11	$158.47	$218.09
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.77 / $37.81 / $55.10	Professional	26	$24.77	$37.81	$55.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $132.06 / $177.95 / $227.69	Professional		$132.06	$177.95	$227.69
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $36.09 / $44.49 / $54.01	Professional	26	$36.09	$44.49	$54.01
United Facility/Professional Professional Modifier Low / Median / High Price $102.58 / $153.87 / $244.19	Professional		$102.58	$153.87	$244.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.32 / $39.20 / $59.07	Professional	26	$26.32	$39.20	$59.07