Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $40.74 / $45.71	Professional		$30.90	$40.74	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $54.95 / $91.20	Professional		$45.71	$54.95	$91.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $478.63 / $676.08	Facility		$141.25	$478.63	$676.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
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 $20.89 / $29.51 / $34.67	Facility		$20.89	$29.51	$34.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $93.33 / $112.20	Professional		$56.23	$93.33	$112.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $70.79 / $100.00	Professional		$47.86	$70.79	$100.00
United Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $60.26 / $104.71	Professional		$40.74	$60.26	$104.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $42.66 / $52.48	Professional		$37.15	$42.66	$52.48