Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $34.67 / $44.67	Professional		$22.91	$34.67	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $54.95 / $57.54	Professional		$51.29	$54.95	$57.54
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 $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
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 $67.61 / $81.28 / $81.28	Facility		$67.61	$81.28	$81.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Facility		$51.29	$51.29	$51.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $91.20 / $117.49	Professional		$56.23	$91.20	$117.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $74.13 / $102.33	Professional		$46.77	$74.13	$102.33
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 $41.69 / $60.26 / $107.15	Professional		$41.69	$60.26	$107.15