Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3.80 / $64.57 / $218.78	Facility		$3.80	$64.57	$218.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $85.11 / $204.17	Facility	26	$42.66	$85.11	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $44.67 / $64.57	Professional		$15.85	$44.67	$64.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $45.71 / $97.72	Professional	26	$15.85	$45.71	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5.25 / $5.25 / $9.33	Facility		$5.25	$5.25	$9.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Professional	26	$40.74	$40.74	$40.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $100.00 / $128.82	Professional		$48.98	$100.00	$128.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $95.50 / $117.49	Professional	26	$45.71	$95.50	$117.49
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $64.57 / $125.89	Facility		$29.51	$64.57	$125.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $85.11 / $154.88	Professional		$52.48	$85.11	$154.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $75.86 / $151.36	Professional	26	$40.74	$75.86	$151.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $97.72 / $97.72	Facility		$67.61	$97.72	$97.72
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $74.13 / $91.20	Facility	26	$29.51	$74.13	$91.20
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $36.31 / $91.20	Professional	26	$23.44	$36.31	$91.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $64.57 / $117.49	Facility		$8.13	$64.57	$117.49
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $117.49 / $117.49	Facility	26	$117.49	$117.49	$117.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $93.33 / $2,238,721.14	Professional		$43.65	$93.33	$2,238,721.14
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $40.74 / $131.83	Professional	26	$36.31	$40.74	$131.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $91.20 / $154.88	Professional		$38.90	$91.20	$154.88
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $85.11 / $144.54	Professional	26	$38.90	$85.11	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $34.67 / $131.83	Professional		$19.05	$34.67	$131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $34.67 / $123.03	Professional	26	$19.05	$34.67	$123.03