Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $186.21 / $213.80	Facility	26	$134.90	$186.21	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $323.59	Professional		$112.20	$147.91	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $288.40 / $398.11	Professional		$190.55	$288.40	$398.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $302.00 / $363.08	Professional		$141.25	$302.00	$363.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $186.21 / $218.78	Professional	26	$83.18	$186.21	$218.78
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $257.04 / $426.58	Professional		$125.89	$257.04	$426.58
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $165.96 / $165.96	Facility	26	$134.90	$165.96	$165.96
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $95.50	Professional		$69.18	$95.50	$95.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $288.40 / $389.05	Professional		$208.93	$288.40	$389.05
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $812.83 / $812.83 / $812.83	Facility	26	$812.83	$812.83	$812.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $281.84 / $363.08	Professional		$239.88	$281.84	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $154.88 / $398.11	Professional		$117.49	$154.88	$398.11