Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.18 / $129.80 / $261.36	Facility	26	$113.18	$129.80	$261.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.99 / $188.50 / $266.68	Professional		$92.99	$188.50	$266.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.14 / $61.14 / $61.14	Facility	26	$61.14	$61.14	$61.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.02 / $263.26 / $410.47	Professional		$174.02	$263.26	$410.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $230.39 / $272.89 / $312.56	Professional		$230.39	$272.89	$312.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $99.41 / $118.32 / $133.21	Professional	26	$99.41	$118.32	$133.21
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $193.56 / $235.80 / $373.46	Professional		$193.56	$235.80	$373.46
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $78.89 / $102.46 / $107.20	Facility	26	$78.89	$102.46	$107.20
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $61.14 / $61.14 / $61.14	Facility	26	$61.14	$61.14	$61.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $211.56 / $285.68 / $359.30	Professional		$211.56	$285.68	$359.30
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,064.48 / $2,064.48 / $2,064.48	Facility	26	$2,064.48	$2,064.48	$2,064.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $214.26 / $279.20 / $339.21	Professional		$214.26	$279.20	$339.21
United Facility/Professional Professional Modifier Low / Median / High Price $133.16 / $221.40 / $380.89	Professional		$133.16	$221.40	$380.89