Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Facility		$51.29	$51.29	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $44.67 / $52.48	Professional		$33.11	$44.67	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $64.57 / $75.86	Professional		$61.66	$64.57	$75.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $67.61 / $114.82	Facility		$25.12	$67.61	$114.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $70.79	Professional		$44.67	$50.12	$70.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $102.33 / $104.71	Facility		$72.44	$102.33	$104.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $72.44	Facility		$63.10	$63.10	$72.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $154.88	Professional		$72.44	$104.71	$154.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $85.11 / $162.18	Facility		$54.95	$85.11	$162.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $138.04	Professional		$64.57	$83.18	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $109.65 / $194.98	Facility		$81.28	$109.65	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $66.07 / $128.82	Professional		$47.86	$66.07	$128.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Professional		$53.70	$53.70	$53.70