Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.40 / $62.40 / $68.39	Facility	26	$62.40	$62.40	$68.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.63 / $199.63 / $321.44	Professional		$154.63	$199.63	$321.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.43 / $31.43 / $31.43	Facility	26	$31.43	$31.43	$31.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.90 / $313.66 / $491.25	Professional		$158.90	$313.66	$491.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $277.06 / $361.25 / $419.92	Professional		$277.06	$361.25	$419.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.66 / $62.08 / $69.89	Professional	26	$47.66	$62.08	$69.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $166.64 / $275.26 / $488.03	Professional		$166.64	$275.26	$488.03
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $38.71 / $52.93 / $54.94	Facility	26	$38.71	$52.93	$54.94
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $31.43 / $31.43 / $31.43	Facility	26	$31.43	$31.43	$31.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $232.78 / $362.29 / $489.44	Professional		$232.78	$362.29	$489.44
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 $264.30 / $354.58 / $504.07	Professional		$264.30	$354.58	$504.07
United Facility/Professional Professional Modifier Low / Median / High Price $213.29 / $304.54 / $560.73	Professional		$213.29	$304.54	$560.73