Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.07 / $43.07 / $48.40	Facility	26	$43.07	$43.07	$48.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.97 / $89.90 / $220.67	Professional		$64.97	$89.90	$220.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.16 / $22.16 / $22.16	Facility	26	$22.16	$22.16	$22.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.82 / $180.28 / $251.55	Professional		$97.82	$180.28	$251.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.40 / $188.27 / $218.48	Professional		$144.40	$188.27	$218.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.17 / $44.56 / $50.24	Professional	26	$34.17	$44.56	$50.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $86.95 / $151.96 / $244.59	Professional		$86.95	$151.96	$244.59
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $27.44 / $37.52 / $38.86	Facility	26	$27.44	$37.52	$38.86
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $22.16 / $22.16 / $22.16	Facility	26	$22.16	$22.16	$22.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $108.97 / $181.97 / $240.77	Professional		$108.97	$181.97	$240.77
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $188.60 / $188.60 / $188.60	Facility	26	$188.60	$188.60	$188.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $127.74 / $175.55 / $235.93	Professional		$127.74	$175.55	$235.93
United Facility/Professional Professional Modifier Low / Median / High Price $117.76 / $184.32 / $264.60	Professional		$117.76	$184.32	$264.60