Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $66.07 / $85.11	Facility	26	$39.81	$66.07	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $85.11 / $165.96	Professional		$66.07	$85.11	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $134.90 / $251.19	Professional		$75.86	$134.90	$251.19
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $41.69 / $79.43	Facility	26	$25.12	$41.69	$79.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $91.20 / $190.55	Professional		$58.88	$91.20	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.11 / $50.12	Professional		$26.92	$33.11	$50.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $60.26 / $61.66	Facility	26	$50.12	$60.26	$61.66
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $41.69 / $41.69	Facility	26	$41.69	$41.69	$41.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $234.42	Professional		$112.20	$165.96	$234.42
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $208.93	Professional		$102.33	$154.88	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $120.23 / $229.09	Professional		$85.11	$120.23	$229.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $100.00 / $169.82	Professional		$89.13	$100.00	$169.82