Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $72.44 / $120.23	Professional		$40.74	$72.44	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $74.13 / $93.33	Professional		$34.67	$74.13	$93.33
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $44.67 / $114.82	Facility	26	$26.92	$44.67	$114.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $208.93	Professional		$97.72	$151.36	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $42.66	Professional		$32.36	$33.11	$42.66
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $36.31 / $47.86	Facility	26	$30.20	$36.31	$47.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $190.55	Professional		$97.72	$151.36	$190.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $165.96	Professional		$91.20	$128.82	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $66.07 / $134.90	Professional		$39.81	$66.07	$134.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Professional		$70.79	$70.79	$70.79