Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $215.56 / $251.31 / $497.48	Facility	26	$215.56	$251.31	$497.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $272.26 / $475.00 / $865.50	Professional		$272.26	$475.00	$865.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.82 / $113.82 / $113.82	Facility	26	$113.82	$113.82	$113.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $364.89 / $685.93 / $1,018.78	Professional		$364.89	$685.93	$1,018.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $673.68 / $769.04 / $925.57	Professional		$673.68	$769.04	$925.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $190.22 / $218.97 / $255.99	Professional	26	$190.22	$218.97	$255.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $545.46 / $719.17 / $1,084.30	Professional		$545.46	$719.17	$1,084.30
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $129.80 / $196.08 / $198.99	Facility	26	$129.80	$196.08	$198.99
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $113.82 / $113.82 / $113.82	Facility	26	$113.82	$113.82	$113.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $528.41 / $781.44 / $1,013.83	Professional		$528.41	$781.44	$1,013.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $630.82 / $812.52 / $1,013.31	Professional		$630.82	$812.52	$1,013.31
United Facility/Professional Professional Modifier Low / Median / High Price $335.29 / $638.07 / $1,169.94	Professional		$335.29	$638.07	$1,169.94