Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.10 / $127.72 / $282.14	Facility	26	$122.10	$127.72	$282.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.87 / $182.21 / $623.00	Professional		$113.87	$182.21	$623.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.96 / $246.40 / $341.23	Professional		$133.96	$246.40	$341.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.09 / $254.16 / $304.62	Professional		$218.09	$254.16	$304.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $105.31 / $124.44 / $143.81	Professional	26	$105.31	$124.44	$143.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $181.47 / $202.42 / $357.84	Professional		$181.47	$202.42	$357.84
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $84.99 / $110.08 / $116.28	Facility	26	$84.99	$110.08	$116.28
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $106.28 / $106.28 / $106.28	Professional		$106.28	$106.28	$106.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $201.78 / $256.77 / $341.23	Professional		$201.78	$256.77	$341.23
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 $214.02 / $279.56 / $333.52	Professional		$214.02	$279.56	$333.52
United Facility/Professional Professional Modifier Low / Median / High Price $123.43 / $148.37 / $353.50	Professional		$123.43	$148.37	$353.50