Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.84 / $103.84 / $114.42	Facility	26	$103.84	$103.84	$114.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.91 / $249.45 / $511.90	Professional		$137.91	$249.45	$511.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.38 / $52.38 / $52.38	Facility	26	$52.38	$52.38	$52.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.14 / $409.95 / $612.17	Professional		$263.14	$409.95	$612.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $466.63 / $556.30 / $646.99	Professional		$466.63	$556.30	$646.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $88.78 / $106.63 / $120.26	Professional	26	$88.78	$106.63	$120.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $352.78 / $425.04 / $618.33	Professional		$352.78	$425.04	$618.33
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $75.23 / $89.78 / $103.49	Facility	26	$75.23	$89.78	$103.49
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $52.38 / $52.38 / $52.38	Facility	26	$52.38	$52.38	$52.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $337.74 / $451.71 / $565.98	Professional		$337.74	$451.71	$565.98
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $838.61 / $838.61 / $838.61	Facility	26	$838.61	$838.61	$838.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $353.88 / $444.49 / $539.13	Professional		$353.88	$444.49	$539.13
United Facility/Professional Professional Modifier Low / Median / High Price $205.35 / $381.23 / $588.12	Professional		$205.35	$381.23	$588.12