Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $193.32 / $193.32 / $212.85	Facility	26	$193.32	$193.32	$212.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.69 / $166.11 / $371.67	Professional		$139.69	$166.11	$371.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.96 / $97.96 / $97.96	Facility	26	$97.96	$97.96	$97.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.55 / $317.02 / $415.60	Professional		$191.55	$317.02	$415.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $262.69 / $342.51 / $391.93	Professional		$262.69	$342.51	$391.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $148.97 / $194.07 / $218.50	Professional	26	$148.97	$194.07	$218.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $235.37 / $269.08 / $460.53	Professional		$235.37	$269.08	$460.53
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $124.46 / $166.92 / $171.52	Facility	26	$124.46	$166.92	$171.52
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $97.96 / $97.96 / $97.96	Facility	26	$97.96	$97.96	$97.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $202.04 / $320.01 / $414.80	Professional		$202.04	$320.01	$414.80
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $459.43 / $459.43 / $459.43	Facility	26	$459.43	$459.43	$459.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $244.62 / $301.92 / $429.22	Professional		$244.62	$301.92	$429.22
United Facility/Professional Professional Modifier Low / Median / High Price $230.04 / $298.20 / $477.47	Professional		$230.04	$298.20	$477.47