Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $123.03 / $131.83	Facility	26	$67.61	$123.03	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $204.17 / $346.74	Professional		$173.78	$204.17	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $363.08 / $602.56	Professional		$199.53	$363.08	$602.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $436.52 / $501.19	Professional		$354.81	$436.52	$501.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $114.82 / $134.90	Professional	26	$95.50	$114.82	$134.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $363.08 / $489.78	Professional		$223.87	$363.08	$489.78
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $102.33 / $104.71	Facility	26	$85.11	$102.33	$104.71
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $58.88 / $85.11	Facility	26	$12.59	$58.88	$85.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $398.11 / $549.54	Professional		$263.03	$398.11	$549.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $416.87 / $512.86	Professional		$281.84	$416.87	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $407.38 / $602.56	Professional		$190.55	$407.38	$602.56