Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.53 / $442.43 / $801.24	Professional		$245.53	$442.43	$801.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.97 / $68.79 / $143.86	Professional	26	$56.97	$68.79	$143.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.71 / $370.19 / $843.91	Professional		$193.71	$370.19	$843.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $81.55 / $125.59	Professional	26	$36.61	$81.55	$125.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $469.99 / $973.50 / $1,387.60	Professional		$469.99	$973.50	$1,387.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $72.11 / $149.36 / $212.90	Professional	26	$72.11	$149.36	$212.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $700.35 / $879.04 / $1,565.97	Professional		$700.35	$879.04	$1,565.97
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $120.09 / $133.33 / $238.72	Professional	26	$120.09	$133.33	$238.72
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $93.24 / $148.07 / $149.41	Facility	26	$93.24	$148.07	$149.41
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $90.05 / $127.10 / $153.18	Professional	26	$90.05	$127.10	$153.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $456.11 / $902.40 / $1,372.70	Professional		$456.11	$902.40	$1,372.70
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $44.04 / $81.55 / $127.62	Professional	26	$44.04	$81.55	$127.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $843.89 / $888.30 / $1,551.80	Professional		$843.89	$888.30	$1,551.80
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $134.06 / $152.69 / $238.74	Professional	26	$134.06	$152.69	$238.74
United Facility/Professional Professional Modifier Low / Median / High Price $236.46 / $236.46 / $1,265.80	Professional		$236.46	$236.46	$1,265.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $79.70 / $236.10	Professional	26	$47.86	$79.70	$236.10