Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $60.26 / $97.72	Facility	26	$30.90	$60.26	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $128.82 / $316.23	Professional		$87.10	$128.82	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $186.21 / $389.05	Professional		$100.00	$186.21	$389.05
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $53.70 / $1,000.00	Facility	26	$30.90	$53.70	$1,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $199.53 / $331.13	Professional		$107.15	$199.53	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $66.07	Professional		$32.36	$33.11	$66.07
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $53.70 / $56.23	Facility	26	$44.67	$53.70	$56.23
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $37.15 / $37.15	Facility	26	$37.15	$37.15	$37.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $371.54	Professional		$173.78	$281.84	$371.54
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $257.04 / $371.54	Professional		$186.21	$257.04	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $138.04 / $323.59	Professional		$97.72	$138.04	$323.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $158.49 / $263.03	Professional		$138.04	$158.49	$263.03