Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.32 / $82.32 / $90.37	Facility	26	$82.32	$82.32	$90.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.25 / $90.86 / $204.78	Professional		$75.25	$90.86	$204.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.39 / $39.82 / $88.92	Professional	26	$34.39	$39.82	$88.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.36 / $41.36 / $41.36	Facility	26	$41.36	$41.36	$41.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.37 / $174.69 / $242.41	Professional		$100.37	$174.69	$242.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.35 / $76.18 / $104.30	Professional	26	$48.35	$76.18	$104.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $146.16 / $190.58 / $219.62	Professional		$146.16	$190.58	$219.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.31 / $83.85 / $94.56	Professional	26	$64.31	$83.85	$94.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $130.19 / $146.56 / $254.16	Professional		$130.19	$146.56	$254.16
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.18 / $70.52 / $115.65	Professional	26	$58.18	$70.52	$115.65
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $52.33 / $71.98 / $73.03	Facility	26	$52.33	$71.98	$73.03
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $43.01 / $52.34 / $73.44	Professional	26	$43.01	$52.34	$73.44
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $41.36 / $41.36 / $41.36	Facility	26	$41.36	$41.36	$41.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $113.46 / $178.36 / $233.02	Professional		$113.46	$178.36	$233.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $49.83 / $76.48 / $104.30	Professional	26	$49.83	$76.48	$104.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $129.15 / $166.63 / $236.88	Professional		$129.15	$166.63	$236.88
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $55.92 / $72.65 / $103.28	Professional	26	$55.92	$72.65	$103.28
United Facility/Professional Professional Modifier Low / Median / High Price $127.25 / $181.86 / $258.83	Professional		$127.25	$181.86	$258.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.71 / $75.61 / $114.90	Professional	26	$53.71	$75.61	$114.90