Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.06 / $290.24 / $383.08	Facility	26	$167.06	$290.24	$383.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.49 / $484.43 / $765.60	Professional		$281.49	$484.43	$765.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.60 / $87.60 / $87.60	Facility	26	$87.60	$87.60	$87.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.64 / $573.58 / $919.70	Professional		$297.64	$573.58	$919.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $536.30 / $613.71 / $737.36	Professional		$536.30	$613.71	$737.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $146.03 / $168.11 / $196.51	Professional	26	$146.03	$168.11	$196.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $447.07 / $618.00 / $981.76	Professional		$447.07	$618.00	$981.76
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $113.19 / $150.53 / $155.44	Facility	26	$113.19	$150.53	$155.44
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $268.35 / $268.35 / $268.35	Professional		$268.35	$268.35	$268.35
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $87.60 / $87.60 / $87.60	Facility	26	$87.60	$87.60	$87.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $457.24 / $678.40 / $863.73	Professional		$457.24	$678.40	$863.73
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,538.06 / $1,538.06 / $1,538.06	Facility	26	$1,538.06	$1,538.06	$1,538.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $503.34 / $679.37 / $843.17	Professional		$503.34	$679.37	$843.17
United Facility/Professional Professional Modifier Low / Median / High Price $267.50 / $495.47 / $894.73	Professional		$267.50	$495.47	$894.73