Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $89.13 / $147.91	Facility	26	$44.67	$89.13	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $117.49 / $309.03	Professional		$75.86	$117.49	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $39.81 / $120.23	Professional	26	$32.36	$39.81	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $199.53 / $363.08	Professional		$95.50	$199.53	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $63.10 / $114.82	Professional	26	$35.48	$63.10	$114.82
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $77.62 / $4,897.79	Facility	26	$45.71	$77.62	$4,897.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $194.98 / $281.84	Professional		$109.65	$194.98	$281.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $72.44 / $102.33	Professional	26	$40.74	$72.44	$102.33
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 $64.57 / $77.62 / $83.18	Facility	26	$64.57	$77.62	$83.18
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $72.44 / $89.13	Professional	26	$48.98	$72.44	$89.13
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $53.70 / $53.70	Facility	26	$53.70	$53.70	$53.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $251.19 / $331.13	Professional		$151.36	$251.19	$331.13
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $85.11 / $117.49	Professional	26	$53.70	$85.11	$117.49
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Facility	26	$3,388.44	$3,388.44	$3,388.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $229.09 / $309.03	Professional		$154.88	$229.09	$309.03
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $112.20	Professional	26	$54.95	$85.11	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $302.00	Professional		$102.33	$138.04	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $45.71 / $104.71	Professional	26	$37.15	$45.71	$104.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $239.88	Professional		$125.89	$147.91	$239.88
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $46.77 / $77.62	Professional	26	$40.74	$46.77	$77.62