Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $39.81 / $48.98	Professional		$26.92	$39.81	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $58.88 / $109.65	Professional		$46.77	$58.88	$109.65
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 $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
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 $29.51 / $42.66 / $44.67	Facility		$29.51	$42.66	$44.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $102.33 / $128.82	Professional		$60.26	$102.33	$128.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $81.28 / $112.20	Professional		$51.29	$81.28	$112.20
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 $48.98 / $70.79 / $120.23	Professional		$48.98	$70.79	$120.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $53.70 / $66.07	Professional		$46.77	$53.70	$66.07