Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.53 / $70.69 / $142.86	Facility	26	$61.53	$70.69	$142.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.69 / $87.25 / $456.48	Professional		$60.69	$87.25	$456.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.37 / $197.94 / $291.38	Professional		$100.37	$197.94	$291.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.02 / $232.88 / $279.38	Professional		$194.02	$232.88	$279.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.40 / $61.52 / $72.23	Professional	26	$51.40	$61.52	$72.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.00 / $164.39 / $273.70	Professional		$97.00	$164.39	$273.70
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $41.18 / $55.37 / $57.62	Facility	26	$41.18	$55.37	$57.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $143.15 / $205.75 / $290.18	Professional		$143.15	$205.75	$290.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $164.21 / $242.57 / $315.43	Professional		$164.21	$242.57	$315.43
United Facility/Professional Professional Modifier Low / Median / High Price $86.24 / $102.86 / $312.08	Professional		$86.24	$102.86	$312.08