Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $151.36 / $251.19	Facility	26	$70.79	$151.36	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $151.36 / $331.13	Professional		$112.20	$151.36	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $302.00 / $467.74	Professional		$181.97	$302.00	$467.74
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $165.96 / $1,584.89	Facility	26	$95.50	$165.96	$1,584.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $316.23 / $426.58	Professional		$190.55	$316.23	$426.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $141.25 / $147.91	Facility	26	$117.49	$141.25	$147.91
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $85.11 / $199.53	Professional		$77.62	$85.11	$199.53
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $97.72 / $100.00	Facility	26	$97.72	$97.72	$100.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $331.13 / $436.52	Professional		$204.17	$331.13	$436.52
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	26	$660.69	$660.69	$660.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $416.87	Professional		$199.53	$309.03	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $380.19	Professional		$131.83	$190.55	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $295.12	Professional		$154.88	$208.93	$295.12