Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $223.87 / $346.74	Facility	26	$173.78	$223.87	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $977.24 / $1,862.09	Professional		$794.33	$977.24	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,659.59 / $2,754.23	Professional		$891.25	$1,659.59	$2,754.23
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $295.12 / $13,803.84	Facility	26	$199.53	$295.12	$13,803.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,905.46 / $2,818.38	Professional		$1,096.48	$1,905.46	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $245.47 / $257.04	Facility	26	$208.93	$245.47	$257.04
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $173.78 / $173.78	Facility	26	$173.78	$173.78	$173.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,949.84 / $2,398.83	Professional		$1,174.90	$1,949.84	$2,398.83
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,623.41 / $5,623.41 / $5,623.41	Facility	26	$5,623.41	$5,623.41	$5,623.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,621.81 / $2,238.72	Professional		$1,258.93	$1,621.81	$2,238.72
United Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,230.27 / $2,290.87	Professional		$870.96	$1,230.27	$2,290.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,202.26 / $1,698.24	Professional		$1,023.29	$1,202.26	$1,698.24