Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.34 / $29.34 / $29.34	Facility	26	$29.34	$29.34	$29.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.99 / $66.72 / $302.61	Professional		$47.99	$66.72	$302.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.07 / $29.08 / $50.50	Professional	26	$26.07	$29.08	$50.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.02 / $158.02 / $158.02	Professional		$158.02	$158.02	$158.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.27 / $28.27 / $28.27	Professional	26	$28.27	$28.27	$28.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $359.12 / $417.81 / $486.44	Professional		$359.12	$417.81	$486.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.22 / $73.30 / $82.92	Professional	26	$61.22	$73.30	$82.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $185.36 / $310.89 / $563.37	Professional		$185.36	$310.89	$563.37
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.70 / $72.22 / $100.79	Professional	26	$50.70	$72.22	$100.79
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $41.18 / $60.77 / $62.98	Facility	26	$41.18	$60.77	$62.98
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $38.76 / $51.70 / $62.98	Professional	26	$38.76	$51.70	$62.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.01 / $320.01 / $495.88	Professional		$109.01	$320.01	$495.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.27 / $28.27 / $41.68	Professional	26	$28.27	$28.27	$41.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $189.59 / $419.31 / $510.70	Professional		$189.59	$419.31	$510.70
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $52.44 / $74.08 / $89.07	Professional	26	$52.44	$74.08	$89.07
United Facility/Professional Professional Modifier Low / Median / High Price $64.68 / $198.61 / $470.77	Professional		$64.68	$198.61	$470.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.28 / $41.05 / $97.37	Professional	26	$37.28	$41.05	$97.37