Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $44.67 / $60.26	Facility	26	$26.92	$44.67	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $154.88 / $338.84	Professional		$104.71	$154.88	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Professional		$263.03	$263.03	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $154.88 / $407.38	Professional		$69.18	$154.88	$407.38
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $35.48 / $645.65	Facility	26	$20.89	$35.48	$645.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $125.89 / $354.81	Professional		$30.90	$125.89	$354.81
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 $28.18 / $38.90 / $47.86	Facility	26	$28.18	$38.90	$47.86
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $31.62 / $32.36	Facility	26	$31.62	$31.62	$32.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $302.00 / $389.05	Professional		$186.21	$302.00	$389.05
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 $138.04 / $275.42 / $380.19	Professional		$138.04	$275.42	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $147.91 / $371.54	Professional		$75.86	$147.91	$371.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $162.18 / $263.03	Professional		$141.25	$162.18	$263.03