Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $63.10 / $102.33	Facility	26	$32.36	$63.10	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $107.15 / $416.87	Professional		$61.66	$107.15	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $147.91	Professional		$109.65	$109.65	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $158.49 / $323.59	Professional		$77.62	$158.49	$323.59
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $41.69 / $70.79	Facility	26	$29.51	$41.69	$70.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $147.91 / $269.15	Professional		$83.18	$147.91	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $50.12	Professional		$32.36	$33.11	$50.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $54.95 / $57.54	Facility	26	$45.71	$54.95	$57.54
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $38.90 / $38.90	Facility	26	$38.90	$38.90	$38.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $229.09 / $295.12	Professional		$144.54	$229.09	$295.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $199.53 / $269.15	Professional		$144.54	$199.53	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $257.04	Professional		$72.44	$102.33	$257.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $125.89 / $208.93	Professional		$109.65	$125.89	$208.93