Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.10 / $168.53 / $340.07	Facility	26	$147.10	$168.53	$340.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.86 / $407.60 / $735.85	Professional		$183.86	$407.60	$735.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $472.74 / $640.57 / $825.86	Professional		$472.74	$640.57	$825.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.30 / $616.90 / $656.71	Professional		$275.30	$616.90	$656.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.48 / $155.61 / $160.97	Professional	26	$67.48	$155.61	$160.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $439.50 / $465.92 / $824.04	Professional		$439.50	$465.92	$824.04
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $97.87 / $134.34 / $139.38	Facility	26	$97.87	$134.34	$139.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $429.31 / $640.57 / $749.16	Professional		$429.31	$640.57	$749.16
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,177.68 / $1,177.68 / $1,177.68	Facility	26	$1,177.68	$1,177.68	$1,177.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $509.04 / $653.45 / $765.58	Professional		$509.04	$653.45	$765.58
United Facility/Professional Professional Modifier Low / Median / High Price $253.39 / $255.65 / $853.75	Professional		$253.39	$255.65	$853.75