Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $125.89 / $177.83	Facility	26	$81.28	$125.89	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $331.13	Professional		$107.15	$147.91	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $218.78 / $389.05	Professional		$114.82	$218.78	$389.05
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $102.33 / $2,630.27	Facility	26	$60.26	$102.33	$2,630.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $257.04 / $346.74	Professional		$131.83	$257.04	$346.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $112.20 / $134.90	Facility	26	$85.11	$112.20	$134.90
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $91.20 / $93.33	Facility	26	$91.20	$91.20	$93.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $295.12 / $389.05	Professional		$181.97	$295.12	$389.05
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility	26	$2,754.23	$2,754.23	$2,754.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $281.84 / $371.54	Professional		$186.21	$281.84	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $338.84	Professional		$114.82	$147.91	$338.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $158.49 / $263.03	Professional		$138.04	$158.49	$263.03