Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $199.53 / $323.59	Facility	26	$93.33	$199.53	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $323.59 / $758.58	Professional		$218.78	$323.59	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $602.56 / $1,047.13	Professional		$323.59	$602.56	$1,047.13
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $218.78 / $1,584.89	Facility	26	$123.03	$218.78	$1,584.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $602.56 / $851.14	Professional		$354.81	$602.56	$851.14
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 $154.88 / $186.21 / $190.55	Facility	26	$154.88	$186.21	$190.55
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $131.83	Facility	26	$128.82	$128.82	$131.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $707.95 / $954.99	Professional		$446.68	$707.95	$954.99
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 $436.52 / $676.08 / $912.01	Professional		$436.52	$676.08	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $363.08 / $794.33	Professional		$229.09	$363.08	$794.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $457.09 / $645.65	Professional		$338.84	$457.09	$645.65