Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $163.63 / $187.88 / $379.71	Facility	26	$163.63	$187.88	$379.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.30 / $494.18 / $850.10	Professional		$300.30	$494.18	$850.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.80 / $86.80 / $86.80	Facility	26	$86.80	$86.80	$86.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.77 / $681.28 / $1,032.34	Professional		$352.77	$681.28	$1,032.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $633.39 / $728.06 / $873.67	Professional		$633.39	$728.06	$873.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $144.74 / $166.62 / $194.82	Professional	26	$144.74	$166.62	$194.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $527.90 / $669.63 / $1,013.58	Professional		$527.90	$669.63	$1,013.58
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $114.31 / $149.19 / $154.10	Facility	26	$114.31	$149.19	$154.10
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $160.34 / $160.34 / $178.16	Professional		$160.34	$160.34	$178.16
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $86.80 / $86.80 / $86.80	Facility	26	$86.80	$86.80	$86.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $535.39 / $785.46 / $1,003.94	Professional		$535.39	$785.46	$1,003.94
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $782.93 / $782.93 / $782.93	Facility	26	$782.93	$782.93	$782.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $596.70 / $783.04 / $944.66	Professional		$596.70	$783.04	$944.66
United Facility/Professional Professional Modifier Low / Median / High Price $320.88 / $515.76 / $1,060.72	Professional		$320.88	$515.76	$1,060.72