Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.45 / $85.44 / $252.05	Facility	26	$69.45	$85.44	$252.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.20 / $159.80 / $597.50	Professional		$110.20	$159.80	$597.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.30 / $244.64 / $350.08	Professional		$132.30	$244.64	$350.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $228.00 / $265.70 / $320.08	Professional		$228.00	$265.70	$320.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $94.08 / $111.14 / $128.46	Professional	26	$94.08	$111.14	$128.46
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $201.51 / $355.83	Professional		$169.00	$201.51	$355.83
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $74.97 / $98.30 / $104.04	Facility	26	$74.97	$98.30	$104.04
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $78.25 / $86.94 / $86.94	Professional		$78.25	$86.94	$86.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $203.13 / $256.52 / $341.15	Professional		$203.13	$256.52	$341.15
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 $209.48 / $274.52 / $331.63	Professional		$209.48	$274.52	$331.63
United Facility/Professional Professional Modifier Low / Median / High Price $120.18 / $142.19 / $368.92	Professional		$120.18	$142.19	$368.92