Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.54 / $117.54 / $130.61	Facility	26	$117.54	$117.54	$130.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.84 / $196.90 / $484.64	Professional		$175.84	$196.90	$484.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.66 / $59.66 / $59.66	Facility	26	$59.66	$59.66	$59.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.28 / $406.85 / $590.64	Professional		$238.28	$406.85	$590.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $327.22 / $426.65 / $494.54	Professional		$327.22	$426.65	$494.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $92.09 / $120.07 / $135.47	Professional	26	$92.09	$120.07	$135.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $241.28 / $351.94 / $560.91	Professional		$241.28	$351.94	$560.91
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $101.84 / $104.52	Facility	26	$74.13	$101.84	$104.52
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $59.66 / $59.66 / $59.66	Facility	26	$59.66	$59.66	$59.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $260.04 / $428.40 / $558.78	Professional		$260.04	$428.40	$558.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $309.41 / $416.65 / $544.80	Professional		$309.41	$416.65	$544.80
United Facility/Professional Professional Modifier Low / Median / High Price $302.94 / $456.80 / $608.25	Professional		$302.94	$456.80	$608.25