Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $51.29 / $85.11	Facility	26	$25.12	$51.29	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $331.13	Professional		$89.13	$131.83	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $22.91 / $56.23	Professional	26	$18.20	$22.91	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $199.53 / $407.38	Professional		$104.71	$199.53	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $37.15 / $67.61	Professional	26	$20.42	$37.15	$67.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $45.71 / $489.78	Facility	26	$26.92	$45.71	$489.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $208.93 / $354.81	Professional		$109.65	$208.93	$354.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $42.66 / $58.88	Professional	26	$22.91	$42.66	$58.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $74.13	Professional		$32.36	$33.11	$74.13
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $44.67 / $46.77	Facility	26	$37.15	$44.67	$46.77
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $41.69 / $51.29	Professional	26	$28.18	$41.69	$51.29
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $30.90 / $31.62	Facility	26	$30.90	$30.90	$31.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $295.12 / $389.05	Professional		$186.21	$295.12	$389.05
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $51.29 / $67.61	Professional	26	$31.62	$51.29	$67.61
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 $190.55 / $269.15 / $380.19	Professional		$190.55	$269.15	$380.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $47.86 / $66.07	Professional	26	$32.36	$47.86	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $338.84	Professional		$102.33	$138.04	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $26.30 / $60.26	Professional	26	$21.38	$26.30	$60.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $158.49 / $263.03	Professional		$138.04	$158.49	$263.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $26.30 / $43.65	Professional	26	$22.91	$26.30	$43.65