Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $190.55 / $269.15 / $316.23	Facility	26	$190.55	$269.15	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $363.08 / $758.58	Professional		$275.42	$363.08	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $724.44 / $1,479.11	Professional		$446.68	$724.44	$1,479.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,023.29 / $1,288.25	Professional		$891.25	$1,023.29	$1,288.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $251.19 / $302.00	Professional	26	$218.78	$251.19	$302.00
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $316.23 / $316.23 / $316.23	Facility	26	$316.23	$316.23	$316.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $1,000.00 / $1,412.54	Professional		$457.09	$1,000.00	$1,412.54
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $194.98 / $234.42 / $239.88	Facility	26	$194.98	$234.42	$239.88
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $134.90 / $194.98	Facility	26	$28.84	$134.90	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $1,047.13 / $1,445.44	Professional		$512.86	$1,047.13	$1,445.44
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 $870.96 / $1,071.52 / $1,348.96	Professional		$870.96	$1,071.52	$1,348.96
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $575.44 / $1,479.11	Professional		$446.68	$575.44	$1,479.11