Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $41.69 / $53.70	Facility	26	$25.12	$41.69	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $89.13 / $181.97	Professional		$67.61	$89.13	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $138.04 / $257.04	Professional		$50.12	$138.04	$257.04
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $25.70 / $48.98	Facility	26	$15.85	$25.70	$48.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $102.33 / $208.93	Professional		$40.74	$102.33	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $33.11 / $52.48	Professional		$15.14	$33.11	$52.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $38.02 / $38.90	Facility	26	$31.62	$38.02	$38.90
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $26.30	Facility	26	$25.70	$25.70	$26.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $234.42	Professional		$114.82	$169.82	$234.42
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	26	$218.78	$218.78	$218.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $213.80	Professional		$100.00	$158.49	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $128.82 / $239.88	Professional		$67.61	$128.82	$239.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $104.71 / $169.82	Professional		$91.20	$104.71	$169.82