Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.26 / $69.26 / $76.83	Facility	26	$69.26	$69.26	$76.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.97 / $82.38 / $190.41	Professional		$72.97	$82.38	$190.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.17 / $35.17 / $35.17	Facility	26	$35.17	$35.17	$35.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.32 / $170.40 / $236.65	Professional		$94.32	$170.40	$236.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $143.84 / $187.54 / $216.45	Professional		$143.84	$187.54	$216.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.24 / $70.72 / $79.70	Professional	26	$54.24	$70.72	$79.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $143.62 / $242.64	Professional		$109.44	$143.62	$242.64
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $43.61 / $59.65 / $61.64	Facility	26	$43.61	$59.65	$61.64
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $50.15 / $50.15 / $50.15	Professional		$50.15	$50.15	$50.15
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $35.17 / $35.17 / $35.17	Facility	26	$35.17	$35.17	$35.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.25 / $174.75 / $227.32	Professional		$109.25	$174.75	$227.32
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 $126.20 / $166.25 / $233.09	Professional		$126.20	$166.25	$233.09
United Facility/Professional Professional Modifier Low / Median / High Price $107.71 / $163.11 / $254.85	Professional		$107.71	$163.11	$254.85