Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $69.18 / $134.90	Facility	26	$41.69	$69.18	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $281.84 / $676.08	Professional		$147.91	$281.84	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.69 / $169.82	Professional	26	$30.90	$41.69	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $588.84 / $891.25	Professional		$371.54	$588.84	$891.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $77.62 / $123.03	Professional	26	$48.98	$77.62	$123.03
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $91.20 / $1,819.70	Facility	26	$58.88	$91.20	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $676.08 / $891.25	Professional		$467.74	$676.08	$891.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $104.71	Professional	26	$58.88	$85.11	$104.71
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 $61.66 / $74.13 / $75.86	Facility	26	$61.66	$74.13	$75.86
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $69.18 / $87.10	Professional	26	$44.67	$69.18	$87.10
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $50.12 / $51.29	Facility	26	$50.12	$50.12	$51.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $616.60 / $776.25	Professional		$371.54	$616.60	$776.25
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $85.11 / $109.65	Professional	26	$51.29	$85.11	$109.65
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 $380.19 / $588.84 / $794.33	Professional		$380.19	$588.84	$794.33
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $79.43 / $107.15	Professional	26	$51.29	$79.43	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $269.15 / $776.25	Professional		$162.18	$269.15	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $39.81 / $104.71	Professional	26	$33.11	$39.81	$104.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $512.86	Professional		$316.23	$371.54	$512.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $50.12 / $70.79	Professional	26	$42.66	$50.12	$70.79