Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.49 / $60.56 / $121.92	Facility	26	$53.49	$60.56	$121.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.21 / $66.06 / $171.74	Professional		$49.21	$66.06	$171.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.28 / $28.28 / $28.28	Facility	26	$28.28	$28.28	$28.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.72 / $115.20 / $166.14	Professional		$64.72	$115.20	$166.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.27 / $140.05 / $160.91	Professional		$118.27	$140.05	$160.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.02 / $56.01 / $63.06	Professional	26	$47.02	$56.01	$63.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $90.16 / $105.38 / $181.66	Professional		$90.16	$105.38	$181.66
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $36.75 / $48.47 / $50.32	Facility	26	$36.75	$48.47	$50.32
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $28.28 / $28.28 / $28.28	Facility	26	$28.28	$28.28	$28.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.04 / $129.87 / $173.09	Professional		$92.04	$129.87	$173.09
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $782.93 / $782.93 / $782.93	Facility	26	$782.93	$782.93	$782.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $107.73 / $124.41 / $165.85	Professional		$107.73	$124.41	$165.85
United Facility/Professional Professional Modifier Low / Median / High Price $55.85 / $86.84 / $199.18	Professional		$55.85	$86.84	$199.18