Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $194.98 / $309.03 / $416.87	Facility	26	$194.98	$309.03	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $208.93 / $457.09	Professional		$169.82	$208.93	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $309.03 / $575.44	Professional		$177.83	$309.03	$575.44
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $194.98 / $380.19	Facility	26	$123.03	$194.98	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $229.09 / $446.68	Professional		$147.91	$229.09	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $33.11 / $117.49	Professional		$30.90	$33.11	$117.49
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $288.40 / $295.12	Facility	26	$213.80	$288.40	$295.12
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	26	$199.53	$199.53	$199.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $537.03	Professional		$257.04	$389.05	$537.03
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	26	$269.15	$269.15	$269.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $363.08 / $478.63	Professional		$245.47	$363.08	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $295.12 / $549.54	Professional		$204.17	$295.12	$549.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $245.47 / $416.87	Professional		$223.87	$245.47	$416.87