Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $51.29 / $100.00	Facility	26	$30.90	$51.29	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $114.82 / $338.84	Professional		$60.26	$114.82	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $128.82 / $245.47	Professional		$114.82	$128.82	$245.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	26	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $120.23 / $218.78	Professional		$69.18	$120.23	$218.78
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $53.70 / $288.40	Facility	26	$31.62	$53.70	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $131.83 / $186.21	Professional		$72.44	$131.83	$186.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $53.70 / $56.23	Facility	26	$44.67	$53.70	$56.23
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $45.71	Professional		$45.71	$45.71	$45.71
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $36.31 / $37.15	Facility	26	$36.31	$36.31	$37.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $158.49 / $199.53	Professional		$95.50	$158.49	$199.53
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $141.25 / $194.98	Professional		$97.72	$141.25	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $181.97	Professional		$67.61	$81.28	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $83.18 / $138.04	Professional		$72.44	$83.18	$138.04