Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $213.80 / $467.74	Facility		$43.65	$213.80	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $37.15 / $56.23	Professional		$28.18	$37.15	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $104.71 / $120.23	Facility		$48.98	$104.71	$120.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $46.77 / $218.78	Facility		$42.66	$46.77	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $46.77 / $79.43	Professional		$38.02	$46.77	$79.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $66.07	Facility		$46.77	$46.77	$66.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $83.18 / $141.25	Facility		$46.77	$83.18	$141.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $56.23	Professional		$42.66	$42.66	$56.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $70.79 / $125.89	Facility		$48.98	$70.79	$125.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $42.66 / $52.48	Professional		$39.81	$42.66	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $56.23 / $56.23	Facility		$46.77	$56.23	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $52.48	Professional		$19.95	$19.95	$52.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $46.77 / $85.11	Professional		$21.38	$46.77	$85.11