Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $218.78 / $354.81	Facility	26	$112.20	$218.78	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $245.47 / $549.54	Professional		$165.96	$245.47	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $380.19 / $741.31	Professional		$208.93	$380.19	$741.31
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $190.55 / $363.08	Facility	26	$114.82	$190.55	$363.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $354.81 / $645.65	Professional		$204.17	$354.81	$645.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $107.15	Professional		$32.36	$33.11	$107.15
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $194.98 / $199.53	Facility	26	$162.18	$194.98	$199.53
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $181.97	Professional		$141.25	$181.97	$181.97
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	26	$134.90	$134.90	$134.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $549.54 / $758.58	Professional		$346.74	$549.54	$758.58
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $457.09 / $660.69	Professional		$346.74	$457.09	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $251.19 / $501.19	Professional		$204.17	$251.19	$501.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $331.13 / $549.54	Professional		$288.40	$331.13	$549.54