Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $255.92 / $314.51 / $591.97	Facility	26	$255.92	$314.51	$591.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.46 / $371.00 / $793.35	Professional		$247.46	$371.00	$793.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $135.43 / $135.43 / $135.43	Facility	26	$135.43	$135.43	$135.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $468.22 / $948.57 / $1,425.14	Professional		$468.22	$948.57	$1,425.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $926.83 / $1,082.08 / $1,276.97	Professional		$926.83	$1,082.08	$1,276.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $226.25 / $260.44 / $304.49	Professional	26	$226.25	$260.44	$304.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $749.88 / $960.75 / $1,490.66	Professional		$749.88	$960.75	$1,490.66
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $174.93 / $233.22 / $239.86	Facility	26	$174.93	$233.22	$239.86
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $140.29 / $140.29 / $140.29	Professional		$140.29	$140.29	$140.29
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $135.43 / $135.43 / $135.43	Facility	26	$135.43	$135.43	$135.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $724.38 / $1,093.31 / $1,412.13	Professional		$724.38	$1,093.31	$1,412.13
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 $879.80 / $1,088.39 / $1,392.83	Professional		$879.80	$1,088.39	$1,392.83
United Facility/Professional Professional Modifier Low / Median / High Price $463.51 / $785.72 / $1,631.69	Professional		$463.51	$785.72	$1,631.69