Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $16.22 / $31.62	Facility	26	$10.00	$16.22	$31.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $34.67 / $100.00	Professional		$22.91	$34.67	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.91 / $26.92	Professional	26	$7.08	$8.91	$26.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $52.48 / $104.71	Professional		$28.84	$52.48	$104.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $14.13 / $25.70	Professional	26	$7.76	$14.13	$25.70
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $16.98 / $165.96	Facility	26	$9.77	$16.98	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $58.88 / $89.13	Professional		$30.90	$58.88	$89.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $15.85 / $21.88	Professional	26	$8.51	$15.85	$21.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $32.36 / $33.11	Professional		$17.38	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $16.98 / $17.38	Facility	26	$14.45	$16.98	$17.38
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.49 / $18.20	Professional	26	$10.47	$15.49	$18.20
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $11.75 / $11.75	Facility	26	$11.75	$11.75	$11.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $75.86 / $100.00	Professional		$47.86	$75.86	$100.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $19.05 / $26.30	Professional	26	$11.75	$19.05	$26.30
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $69.18 / $97.72	Professional		$47.86	$69.18	$97.72
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $18.20 / $24.55	Professional	26	$12.30	$18.20	$24.55
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $37.15 / $87.10	Professional		$28.18	$37.15	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.77 / $22.39	Professional	26	$7.94	$9.77	$22.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $40.74 / $67.61	Professional		$35.48	$40.74	$67.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.23 / $16.60	Professional	26	$8.71	$10.23	$16.60