Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $148.13 / $169.58 / $342.64	Facility	26	$148.13	$169.58	$342.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.35 / $334.02 / $603.70	Professional		$151.35	$334.02	$603.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.34 / $78.34 / $78.34	Facility	26	$78.34	$78.34	$78.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.76 / $431.74 / $655.35	Professional		$229.76	$431.74	$655.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $425.62 / $485.63 / $583.72	Professional		$425.62	$485.63	$583.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $130.09 / $150.87 / $174.99	Professional	26	$130.09	$150.87	$174.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $344.24 / $442.26 / $684.31	Professional		$344.24	$442.26	$684.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $89.26 / $134.09 / $138.02	Facility	26	$89.26	$134.09	$138.02
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $160.34 / $160.34 / $160.34	Professional		$160.34	$160.34	$160.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $78.34 / $78.34 / $78.34	Facility	26	$78.34	$78.34	$78.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $333.45 / $491.40 / $641.96	Professional		$333.45	$491.40	$641.96
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $777.03 / $777.03 / $777.03	Facility	26	$777.03	$777.03	$777.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $396.81 / $510.20 / $641.63	Professional		$396.81	$510.20	$641.63
United Facility/Professional Professional Modifier Low / Median / High Price $211.67 / $463.65 / $735.92	Professional		$211.67	$463.65	$735.92