Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $95.50 / $154.88	Facility	26	$48.98	$95.50	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $120.23 / $281.84	Professional		$77.62	$120.23	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $208.93 / $346.74	Professional		$97.72	$208.93	$346.74
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $85.11 / $1,698.24	Facility	26	$48.98	$85.11	$1,698.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $213.80 / $302.00	Professional		$114.82	$213.80	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $85.11 / $87.10	Facility	26	$70.79	$85.11	$87.10
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	26	$58.88	$58.88	$58.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $251.19 / $331.13	Professional		$154.88	$251.19	$331.13
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility	26	$1,380.38	$1,380.38	$1,380.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $234.42 / $316.23	Professional		$158.49	$234.42	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $141.25 / $302.00	Professional		$107.15	$141.25	$302.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $131.83 / $218.78	Professional		$114.82	$131.83	$218.78