Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.43 / $75.39 / $168.20	Facility	26	$67.43	$75.39	$168.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.17 / $106.18 / $504.00	Professional		$87.17	$106.18	$504.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.20 / $190.40 / $262.56	Professional		$103.20	$190.40	$262.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $168.52 / $196.39 / $237.27	Professional		$168.52	$196.39	$237.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $62.78 / $74.17 / $85.73	Professional	26	$62.78	$74.17	$85.73
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $140.37 / $154.28 / $270.42	Professional		$140.37	$154.28	$270.42
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $50.47 / $65.59 / $69.68	Facility	26	$50.47	$65.59	$69.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $155.55 / $194.95 / $258.99	Professional		$155.55	$194.95	$258.99
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 $163.59 / $212.68 / $252.04	Professional		$163.59	$212.68	$252.04
United Facility/Professional Professional Modifier Low / Median / High Price $92.03 / $104.82 / $275.58	Professional		$92.03	$104.82	$275.58