Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $145.88 / $145.88 / $162.41	Facility	26	$145.88	$145.88	$162.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.73 / $126.42 / $406.00	Professional		$111.73	$126.42	$406.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.27 / $71.43 / $172.59	Professional	26	$60.27	$71.43	$172.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.17 / $74.17 / $74.17	Facility	26	$74.17	$74.17	$74.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.22 / $240.45 / $329.46	Professional		$151.22	$240.45	$329.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.83 / $135.83 / $186.76	Professional	26	$84.83	$135.83	$186.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $197.01 / $256.87 / $294.49	Professional		$197.01	$256.87	$294.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $114.06 / $148.72 / $167.93	Professional	26	$114.06	$148.72	$167.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $176.12 / $212.66 / $337.53	Professional		$176.12	$212.66	$337.53
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $103.01 / $124.86 / $204.77	Professional	26	$103.01	$124.86	$204.77
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $93.02 / $127.75 / $129.97	Facility	26	$93.02	$127.75	$129.97
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $77.20 / $105.60 / $130.08	Professional	26	$77.20	$105.60	$130.08
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $74.17 / $74.17 / $74.17	Facility	26	$74.17	$74.17	$74.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $153.57 / $246.40 / $321.88	Professional		$153.57	$246.40	$321.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $87.88 / $135.83 / $186.76	Professional	26	$87.88	$135.83	$186.76
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 $179.28 / $230.64 / $314.57	Professional		$179.28	$230.64	$314.57
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $103.68 / $127.97 / $181.92	Professional	26	$103.68	$127.97	$181.92
United Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $256.64 / $353.23	Professional		$169.00	$256.64	$353.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $138.82 / $202.36	Professional	26	$97.72	$138.82	$202.36