Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $128.82 / $616.60	Facility	26	$77.62	$128.82	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $288.40 / $602.56	Professional		$186.21	$288.40	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $354.81 / $707.95	Professional		$204.17	$354.81	$707.95
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $134.90 / $204.17	Facility	26	$81.28	$134.90	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $426.58 / $602.56	Professional		$245.47	$426.58	$602.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $40.74	Professional		$32.36	$33.11	$40.74
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $134.90 / $138.04	Facility	26	$112.20	$134.90	$138.04
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $93.33 / $93.33	Facility	26	$93.33	$93.33	$93.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $478.63 / $630.96	Professional		$302.00	$478.63	$630.96
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $457.09 / $616.60	Professional		$309.03	$457.09	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $467.74 / $891.25	Professional		$213.80	$467.74	$891.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $257.04 / $416.87	Professional		$223.87	$257.04	$416.87