Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.23 / $68.75 / $139.05	Facility	26	$59.23	$68.75	$139.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.67 / $102.66 / $286.91	Professional		$59.67	$102.66	$286.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.56 / $149.94 / $208.13	Professional		$83.56	$149.94	$208.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.88 / $153.69 / $185.40	Professional		$131.88	$153.69	$185.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.91 / $61.33 / $70.88	Professional	26	$51.91	$61.33	$70.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $92.82 / $119.93 / $212.46	Professional		$92.82	$119.93	$212.46
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $40.21 / $54.26 / $55.61	Facility	26	$40.21	$54.26	$55.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $119.79 / $151.91 / $204.67	Professional		$119.79	$151.91	$204.67
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 $125.09 / $168.38 / $198.51	Professional		$125.09	$168.38	$198.51
United Facility/Professional Professional Modifier Low / Median / High Price $74.70 / $83.88 / $216.51	Professional		$74.70	$83.88	$216.51