Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $74.13 / $87.10	Facility	26	$46.77	$74.13	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $177.83 / $676.08	Professional		$100.00	$177.83	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $223.87 / $331.13	Professional		$109.65	$223.87	$331.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $245.47 / $309.03	Professional		$199.53	$245.47	$309.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $72.44 / $87.10	Professional	26	$56.23	$72.44	$87.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $223.87 / $338.84	Professional		$144.54	$223.87	$338.84
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $67.61 / $70.79	Facility	26	$56.23	$67.61	$70.79
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $239.88 / $331.13	Professional		$181.97	$239.88	$331.13
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $776.25 / $776.25 / $776.25	Facility	26	$776.25	$776.25	$776.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $316.23	Professional		$208.93	$245.47	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $131.83 / $316.23	Professional		$117.49	$131.83	$316.23