Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $178.23 / $195.61 / $218.00	Facility	26	$178.23	$195.61	$218.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.08 / $486.46 / $1,085.05	Professional		$254.08	$486.46	$1,085.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.54 / $104.54 / $104.54	Facility	26	$104.54	$104.54	$104.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.76 / $762.38 / $1,206.43	Professional		$327.76	$762.38	$1,206.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $706.45 / $919.54 / $1,064.85	Professional		$706.45	$919.54	$1,064.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $158.11 / $202.14 / $227.59	Professional	26	$158.11	$202.14	$227.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $375.76 / $630.86 / $1,254.08	Professional		$375.76	$630.86	$1,254.08
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $123.97 / $162.97 / $184.25	Facility	26	$123.97	$162.97	$184.25
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $160.93 / $160.93 / $160.93	Professional		$160.93	$160.93	$160.93
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $104.54 / $104.54 / $104.54	Facility	26	$104.54	$104.54	$104.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $480.69 / $878.96 / $1,208.48	Professional		$480.69	$878.96	$1,208.48
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $773.56 / $773.56 / $773.56	Facility	26	$773.56	$773.56	$773.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $605.40 / $849.39 / $1,243.11	Professional		$605.40	$849.39	$1,243.11
United Facility/Professional Professional Modifier Low / Median / High Price $449.83 / $734.15 / $1,359.23	Professional		$449.83	$734.15	$1,359.23