Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.06 / $189.59 / $383.08	Facility	26	$167.06	$189.59	$383.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.60 / $475.00 / $733.63	Professional		$257.60	$475.00	$733.63
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 $291.76 / $597.74 / $928.94	Professional		$291.76	$597.74	$928.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $527.04 / $600.45 / $724.38	Professional		$527.04	$600.45	$724.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $146.03 / $168.53 / $196.51	Professional	26	$146.03	$168.53	$196.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $439.37 / $607.36 / $993.92	Professional		$439.37	$607.36	$993.92
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 / $298.17 / $298.17	Professional		$268.35	$298.17	$298.17
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 $447.54 / $669.31 / $862.41	Professional		$447.54	$669.31	$862.41
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 $491.97 / $665.08 / $866.54	Professional		$491.97	$665.08	$866.54
United Facility/Professional Professional Modifier Low / Median / High Price $263.20 / $444.60 / $886.83	Professional		$263.20	$444.60	$886.83