Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $33.11 / $54.95	Facility	26	$15.85	$33.11	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $95.50 / $239.88	Professional		$63.10	$95.50	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $47.86	Professional	26	$12.02	$15.14	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $147.91 / $316.23	Professional		$74.13	$147.91	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $23.99 / $44.67	Professional	26	$13.18	$23.99	$44.67
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $29.51 / $234.42	Facility	26	$16.98	$29.51	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $147.91 / $275.42	Professional		$77.62	$147.91	$275.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $26.92 / $38.02	Professional	26	$14.79	$26.92	$38.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $58.88	Professional		$32.36	$33.11	$58.88
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $29.51 / $30.90	Facility	26	$24.55	$29.51	$30.90
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $25.12 / $33.88	Professional	26	$17.78	$25.12	$33.88
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $20.42	Facility	26	$19.95	$19.95	$20.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $223.87 / $302.00	Professional		$144.54	$223.87	$302.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $33.11 / $44.67	Professional	26	$20.42	$33.11	$44.67
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 $141.25 / $204.17 / $288.40	Professional		$141.25	$204.17	$288.40
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.90 / $42.66	Professional	26	$20.89	$30.90	$42.66
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $97.72 / $234.42	Professional		$70.79	$97.72	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.60 / $38.02	Professional	26	$13.49	$16.60	$38.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $120.23 / $199.53	Professional		$104.71	$120.23	$199.53
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $17.78 / $29.51	Professional	26	$15.49	$17.78	$29.51