Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $48.98 / $81.28	Facility	26	$25.12	$48.98	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $229.09 / $562.34	Professional		$147.91	$229.09	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $436.52 / $741.31	Professional		$218.78	$436.52	$741.31
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $47.86 / $63.10	Facility	26	$28.18	$47.86	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $478.63 / $602.56	Professional		$218.78	$478.63	$602.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $43.65 / $45.71	Facility	26	$36.31	$43.65	$45.71
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $30.20 / $30.90	Facility	26	$30.20	$30.20	$30.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $512.86 / $645.65	Professional		$309.03	$512.86	$645.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $446.68 / $602.56	Professional		$263.03	$446.68	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $223.87 / $524.81	Professional		$158.49	$223.87	$524.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $323.59 / $457.09	Professional		$275.42	$323.59	$457.09