Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $26.30 / $42.66	Facility	26	$19.05	$26.30	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $147.91 / $501.19	Professional		$48.98	$147.91	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $43.65 / $398.11	Professional	26	$12.02	$43.65	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $22.91	Professional	26	$19.50	$19.50	$22.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $93.33 / $158.49	Professional		$46.77	$93.33	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $17.38 / $34.67	Professional	26	$9.77	$17.38	$34.67
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $21.88 / $30.20	Facility	26	$13.49	$21.88	$30.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $104.71 / $138.04	Professional		$58.88	$104.71	$138.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $21.38 / $30.20	Professional	26	$11.48	$21.38	$30.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $32.36 / $33.11	Professional		$22.39	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $22.91 / $23.44	Facility	26	$19.05	$22.91	$23.44
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $20.89 / $26.30	Professional	26	$14.13	$20.89	$26.30
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $15.85 / $15.85	Facility	26	$15.85	$15.85	$15.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $107.15 / $138.04	Professional		$64.57	$107.15	$138.04
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $25.12 / $33.88	Professional	26	$15.85	$25.12	$33.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $100.00 / $138.04	Professional		$67.61	$100.00	$138.04
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $25.12 / $32.36	Professional	26	$16.60	$25.12	$32.36
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $72.44 / $144.54	Professional		$45.71	$72.44	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.49 / $32.36	Professional	26	$10.23	$13.49	$32.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $54.95 / $89.13	Professional		$47.86	$54.95	$89.13
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $13.18 / $21.88	Professional	26	$11.48	$13.18	$21.88