Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $165.96 / $194.98	Facility	26	$104.71	$165.96	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $478.63 / $831.76	Professional		$275.42	$478.63	$831.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $549.54 / $1,096.48	Professional		$281.84	$549.54	$1,096.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $575.44 / $724.44	Professional		$501.19	$575.44	$724.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $162.18 / $194.98	Professional	26	$141.25	$162.18	$194.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $616.60 / $1,000.00	Professional		$446.68	$616.60	$1,000.00
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $151.36 / $154.88	Facility	26	$125.89	$151.36	$154.88
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $125.89	Facility	26	$18.62	$87.10	$125.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $676.08 / $1,023.29	Professional		$302.00	$676.08	$1,023.29
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $851.14 / $851.14 / $851.14	Facility	26	$851.14	$851.14	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $645.65 / $870.96	Professional		$489.78	$645.65	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $524.81 / $933.25	Professional		$263.03	$524.81	$933.25