Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $100.00 / $165.96	Facility	26	$51.29	$100.00	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $371.54 / $741.31	Professional		$269.15	$371.54	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $616.60 / $1,096.48	Professional		$331.13	$616.60	$1,096.48
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $89.13 / $1,047.13	Facility	26	$53.70	$89.13	$1,047.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $707.95 / $1,000.00	Professional		$416.87	$707.95	$1,000.00
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 $74.13 / $89.13 / $93.33	Facility	26	$74.13	$89.13	$93.33
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	26	$61.66	$61.66	$61.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $794.33 / $1,047.13	Professional		$489.78	$794.33	$1,047.13
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 $512.86 / $776.25 / $1,023.29	Professional		$512.86	$776.25	$1,023.29
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $426.58 / $954.99	Professional		$338.84	$426.58	$954.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $416.87 / $691.83	Professional		$363.08	$416.87	$691.83