Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.46 / $66.73 / $135.33	Facility	26	$58.46	$66.73	$135.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.37 / $139.34 / $359.93	Professional		$90.37	$139.34	$359.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.72 / $30.72 / $30.72	Facility	26	$30.72	$30.72	$30.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.64 / $233.56 / $377.26	Professional		$115.64	$233.56	$377.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $258.98 / $308.45 / $358.21	Professional		$258.98	$308.45	$358.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.50 / $61.78 / $69.55	Professional	26	$51.50	$61.78	$69.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $172.50 / $217.60 / $414.78	Professional		$172.50	$217.60	$414.78
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $39.69 / $53.10 / $54.27	Facility	26	$39.69	$53.10	$54.27
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $30.72 / $30.72 / $30.72	Facility	26	$30.72	$30.72	$30.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $184.22 / $276.18 / $392.35	Professional		$184.22	$276.18	$392.35
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $851.78 / $851.78 / $851.78	Facility	26	$851.78	$851.78	$851.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $207.40 / $277.43 / $376.70	Professional		$207.40	$277.43	$376.70
United Facility/Professional Professional Modifier Low / Median / High Price $107.80 / $153.19 / $367.96	Professional		$107.80	$153.19	$367.96