Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $245.47 / $398.11	Facility	26	$123.03	$245.47	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $426.58 / $1,445.44	Professional		$288.40	$426.58	$1,445.44
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 $288.40 / $549.54 / $933.25	Professional		$288.40	$549.54	$933.25
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $213.80 / $630.96	Facility	26	$131.83	$213.80	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $616.60 / $812.83	Professional		$354.81	$616.60	$812.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $109.65	Professional		$32.36	$33.11	$109.65
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $218.78 / $223.87	Facility	26	$177.83	$218.78	$223.87
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	26	$147.91	$147.91	$147.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $645.65 / $831.76	Professional		$389.05	$645.65	$831.76
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $602.56 / $812.83	Professional		$407.38	$602.56	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $407.38 / $851.14	Professional		$275.42	$407.38	$851.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $331.13 / $549.54	Professional		$288.40	$331.13	$549.54