Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.90 / $190.55	Professional		$21.88	$30.90	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $39.81 / $42.66	Professional		$33.88	$39.81	$42.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $57.54 / $60.26	Facility		$40.74	$57.54	$60.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $70.79 / $85.11	Professional		$41.69	$70.79	$85.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $54.95 / $75.86	Professional		$36.31	$54.95	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $45.71 / $77.62	Professional		$30.20	$45.71	$77.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $27.54	Professional		$27.54	$27.54	$27.54