Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $19.95 / $27.54	Facility	26	$12.02	$19.95	$27.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $54.95 / $109.65	Professional		$43.65	$54.95	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $89.13 / $147.91	Professional		$53.70	$89.13	$147.91
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $14.13 / $27.54	Facility	26	$9.33	$14.13	$27.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $77.62 / $123.03	Professional		$51.29	$77.62	$123.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $32.36 / $33.11	Professional		$7.24	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $18.62 / $19.50	Facility	26	$15.49	$18.62	$19.50
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $13.18	Facility	26	$12.88	$12.88	$13.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $95.50 / $141.25	Professional		$66.07	$95.50	$141.25
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $512.86 / $512.86 / $512.86	Facility	26	$512.86	$512.86	$512.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $91.20 / $123.03	Professional		$66.07	$91.20	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $79.43 / $128.82	Professional		$50.12	$79.43	$128.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $60.26 / $100.00	Professional		$52.48	$60.26	$100.00