Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $151.36 / $251.19	Facility	26	$72.44	$151.36	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $794.33	Professional		$281.84	$380.19	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $741.31 / $1,202.26	Professional		$446.68	$741.31	$1,202.26
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $165.96 / $1,174.90	Facility	26	$95.50	$165.96	$1,174.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $794.33 / $1,023.29	Professional		$478.63	$794.33	$1,023.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$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
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 $501.19 / $831.76 / $1,071.52	Professional		$501.19	$831.76	$1,071.52
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $467.74 / $467.74	Facility	26	$467.74	$467.74	$467.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $758.58 / $1,023.29	Professional		$489.78	$758.58	$1,023.29
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $457.09 / $933.25	Professional		$323.59	$457.09	$933.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $524.81 / $724.44	Professional		$389.05	$524.81	$724.44