Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $75.17 / $151.82	Facility	26	$65.64	$75.17	$151.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.26 / $189.68 / $639.64	Professional		$162.26	$189.68	$639.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.14 / $546.85 / $636.64	Professional		$316.14	$546.85	$636.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $240.97 / $537.55 / $574.80	Professional		$240.97	$537.55	$574.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.93 / $69.02 / $71.40	Professional	26	$29.93	$69.02	$71.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $292.74 / $387.19 / $716.70	Professional		$292.74	$387.19	$716.70
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $46.51 / $59.57 / $64.31	Facility	26	$46.51	$59.57	$64.31
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $273.14 / $273.14 / $273.14	Professional		$273.14	$273.14	$273.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $302.94 / $517.67 / $648.29	Professional		$302.94	$517.67	$648.29
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 $353.01 / $512.29 / $667.99	Professional		$353.01	$512.29	$667.99
United Facility/Professional Professional Modifier Low / Median / High Price $168.60 / $278.41 / $782.53	Professional		$168.60	$278.41	$782.53