Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.64 / $55.77 / $112.76	Facility	26	$49.64	$55.77	$112.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.80 / $98.79 / $221.25	Professional		$56.80	$98.79	$221.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.82 / $25.82 / $25.82	Facility	26	$25.82	$25.82	$25.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.47 / $178.06 / $266.76	Professional		$90.47	$178.06	$266.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $160.05 / $190.22 / $220.14	Professional		$160.05	$190.22	$220.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.34 / $51.86 / $58.39	Professional	26	$43.34	$51.86	$58.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $129.69 / $158.43 / $251.10	Professional		$129.69	$158.43	$251.10
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $33.32 / $44.67 / $45.56	Facility	26	$33.32	$44.67	$45.56
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $25.82 / $25.82 / $25.82	Facility	26	$25.82	$25.82	$25.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $143.88 / $191.88 / $245.39	Professional		$143.88	$191.88	$245.39
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $385.75 / $385.75 / $385.75	Facility	26	$385.75	$385.75	$385.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $147.83 / $190.32 / $234.03	Professional		$147.83	$190.32	$234.03
United Facility/Professional Professional Modifier Low / Median / High Price $92.10 / $104.60 / $262.77	Professional		$92.10	$104.60	$262.77