Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.22 / $120.64 / $242.95	Facility	26	$103.22	$120.64	$242.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.22 / $464.01 / $928.07	Professional		$275.22	$464.01	$928.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.81 / $55.81 / $55.81	Facility	26	$55.81	$55.81	$55.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $534.49 / $882.18 / $1,314.77	Professional		$534.49	$882.18	$1,314.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $784.84 / $936.31 / $1,090.64	Professional		$784.84	$936.31	$1,090.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $92.38 / $109.99 / $123.84	Professional	26	$92.38	$109.99	$123.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $635.12 / $814.20 / $1,260.59	Professional		$635.12	$814.20	$1,260.59
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $74.48 / $95.22 / $101.84	Facility	26	$74.48	$95.22	$101.84
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $351.98 / $351.98 / $351.98	Professional		$351.98	$351.98	$351.98
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $55.81 / $55.81 / $55.81	Facility	26	$55.81	$55.81	$55.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $730.53 / $956.04 / $1,225.59	Professional		$730.53	$956.04	$1,225.59
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,526.97 / $1,526.97 / $1,526.97	Facility	26	$1,526.97	$1,526.97	$1,526.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $742.14 / $936.96 / $1,174.90	Professional		$742.14	$936.96	$1,174.90
United Facility/Professional Professional Modifier Low / Median / High Price $377.62 / $577.41 / $1,272.34	Professional		$377.62	$577.41	$1,272.34