Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $19.50 / $32.36	Facility	26	$14.13	$19.50	$32.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $85.11 / $199.53	Professional		$66.07	$85.11	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $173.78 / $269.15	Professional		$109.65	$173.78	$269.15
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $21.88 / $1,819.70	Facility	26	$14.45	$21.88	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $186.21 / $245.47	Professional		$125.89	$186.21	$245.47
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 $14.45 / $16.98 / $18.20	Facility	26	$14.45	$16.98	$18.20
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $11.75 / $11.75	Facility	26	$11.75	$11.75	$11.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $234.42	Professional		$112.20	$186.21	$234.42
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $724.44 / $724.44 / $724.44	Facility	26	$724.44	$724.44	$724.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $169.82 / $229.09	Professional		$109.65	$169.82	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $223.87	Professional		$69.18	$87.10	$223.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $112.20 / $158.49	Professional		$95.50	$112.20	$158.49