Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $186.21 / $912.01	Facility	26	$112.20	$186.21	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $426.58 / $870.96	Professional		$295.12	$426.58	$870.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Professional		$575.44	$575.44	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $562.34 / $1,122.02	Professional		$323.59	$562.34	$1,122.02
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $186.21 / $251.19	Facility	26	$117.49	$186.21	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $676.08 / $954.99	Professional		$389.05	$676.08	$954.99
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 $162.18 / $194.98 / $199.53	Facility	26	$162.18	$194.98	$199.53
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	26	$134.90	$134.90	$134.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $776.25 / $1,000.00	Professional		$478.63	$776.25	$1,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $741.31 / $977.24	Professional		$489.78	$741.31	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $602.56 / $1,148.15	Professional		$338.84	$602.56	$1,148.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $398.11 / $660.69	Professional		$346.74	$398.11	$660.69