Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $72.44 / $141.25	Facility	26	$44.67	$72.44	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $338.84 / $794.33	Professional		$257.04	$338.84	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $616.60 / $933.25	Professional		$398.11	$616.60	$933.25
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $97.72 / $2,344.23	Facility	26	$61.66	$97.72	$2,344.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $707.95 / $933.25	Professional		$489.78	$707.95	$933.25
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 $63.10 / $75.86 / $79.43	Facility	26	$63.10	$75.86	$79.43
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	26	$52.48	$52.48	$52.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $660.69 / $812.83	Professional		$389.05	$660.69	$812.83
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $954.99 / $954.99 / $954.99	Facility	26	$954.99	$954.99	$954.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $630.96 / $851.14	Professional		$407.38	$630.96	$851.14
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $316.23 / $831.76	Professional		$257.04	$316.23	$831.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $389.05 / $549.54	Professional		$331.13	$389.05	$549.54