Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $147.91 / $169.82	Facility	26	$93.33	$147.91	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $295.12	Professional		$107.15	$151.36	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $263.03 / $389.05	Professional		$141.25	$263.03	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $288.40 / $354.81	Professional		$257.04	$288.40	$354.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $144.54 / $173.78	Professional	26	$125.89	$144.54	$173.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $263.03 / $389.05	Professional		$162.18	$263.03	$389.05
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $112.20 / $134.90	Facility	26	$85.11	$112.20	$134.90
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $77.62 / $112.20	Facility	26	$16.60	$77.62	$112.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $288.40 / $389.05	Professional		$213.80	$288.40	$389.05
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $3,311.31 / $3,311.31 / $3,311.31	Facility	26	$3,311.31	$3,311.31	$3,311.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $281.84 / $354.81	Professional		$234.42	$281.84	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $363.08	Professional		$128.82	$158.49	$363.08