Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.18 / $31.18 / $45.08	Facility	26	$31.18	$31.18	$45.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $82.03 / $181.17	Professional		$66.64	$82.03	$181.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.98 / $145.01 / $195.80	Professional		$79.98	$145.01	$195.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.29 / $143.38 / $170.36	Professional		$128.29	$143.38	$170.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.93 / $38.36 / $45.62	Professional	26	$32.93	$38.36	$45.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $129.54 / $170.43	Professional		$95.00	$129.54	$170.43
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $26.46 / $35.51 / $36.18	Facility	26	$26.46	$35.51	$36.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $98.31 / $147.22 / $184.91	Professional		$98.31	$147.22	$184.91
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $354.01 / $354.01 / $354.01	Facility	26	$354.01	$354.01	$354.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $85.43 / $146.60 / $190.13	Professional		$85.43	$146.60	$190.13
United Facility/Professional Professional Modifier Low / Median / High Price $99.44 / $149.61 / $208.07	Professional		$99.44	$149.61	$208.07