Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $177.83 / $194.98	Facility	26	$100.00	$177.83	$194.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $169.82 / $199.53	Professional	26	$141.25	$169.82	$199.53
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $151.36 / $154.88	Facility	26	$125.89	$151.36	$154.88
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $125.89	Facility	26	$18.62	$87.10	$125.89
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Facility	26	$3,019.95	$3,019.95	$3,019.95