Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.52 / $55.56 / $125.04	Facility	26	$52.52	$55.56	$125.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.35 / $67.41 / $166.06	Professional		$47.35	$67.41	$166.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.83 / $125.16 / $171.82	Professional		$64.83	$125.16	$171.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.84 / $132.66 / $160.29	Professional		$113.84	$132.66	$160.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.69 / $51.52 / $59.66	Professional	26	$43.69	$51.52	$59.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.01 / $116.31 / $188.86	Professional		$95.01	$116.31	$188.86
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $30.34 / $45.56 / $49.58	Facility	26	$30.34	$45.56	$49.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $100.58 / $132.68 / $177.51	Professional		$100.58	$132.68	$177.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.09 / $146.88 / $173.39	Professional		$112.09	$146.88	$173.39
United Facility/Professional Professional Modifier Low / Median / High Price $60.01 / $65.80 / $176.73	Professional		$60.01	$65.80	$176.73