Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.43 / $107.30 / $216.86	Facility	26	$94.43	$107.30	$216.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.48 / $145.18 / $300.91	Professional		$75.48	$145.18	$300.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.75 / $49.75 / $49.75	Facility	26	$49.75	$49.75	$49.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.44 / $225.92 / $330.42	Professional		$146.44	$225.92	$330.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $219.46 / $250.80 / $299.48	Professional		$219.46	$250.80	$299.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $82.39 / $95.66 / $110.86	Professional	26	$82.39	$95.66	$110.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $166.20 / $217.29 / $350.73	Professional		$166.20	$217.29	$350.73
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $63.70 / $84.92 / $87.10	Facility	26	$63.70	$84.92	$87.10
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $49.75 / $49.75 / $49.75	Facility	26	$49.75	$49.75	$49.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $168.97 / $249.12 / $325.92	Professional		$168.97	$249.12	$325.92
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,298.07 / $2,298.07 / $2,298.07	Facility	26	$2,298.07	$2,298.07	$2,298.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $206.48 / $237.39 / $318.58	Professional		$206.48	$237.39	$318.58
United Facility/Professional Professional Modifier Low / Median / High Price $99.77 / $147.32 / $324.55	Professional		$99.77	$147.32	$324.55