Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $112.20 / $144.54	Facility	26	$67.61	$112.20	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $208.93 / $380.19	Professional		$169.82	$208.93	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $323.59 / $588.84	Professional		$177.83	$323.59	$588.84
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $69.18 / $123.03	Facility	26	$42.66	$69.18	$123.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $239.88 / $478.63	Professional		$125.89	$239.88	$478.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $107.15	Professional		$32.36	$33.11	$107.15
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $102.33 / $104.71	Facility	26	$85.11	$102.33	$104.71
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $524.81	Professional		$263.03	$389.05	$524.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $363.08 / $489.78	Professional		$245.47	$363.08	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $562.34	Professional		$194.98	$302.00	$562.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $234.42 / $389.05	Professional		$204.17	$234.42	$389.05