Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $32.36 / $43.65	Professional		$20.89	$32.36	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $47.86 / $58.88	Professional		$38.90	$47.86	$58.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $107.15 / $158.49	Facility		$34.67	$107.15	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $50.12	Professional		$32.36	$44.67	$50.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $66.07 / $67.61	Facility		$56.23	$66.07	$67.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Facility		$43.65	$43.65	$43.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $75.86 / $104.71	Professional		$46.77	$75.86	$104.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $61.66 / $87.10	Professional		$38.90	$61.66	$87.10
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.90 / $79.43	Professional		$25.12	$38.90	$79.43