Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $70.79 / $114.82	Facility		$52.48	$70.79	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $42.66 / $97.72	Professional		$26.92	$42.66	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $64.57	Facility		$54.95	$54.95	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $58.88 / $123.03	Professional		$34.67	$58.88	$123.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $57.54 / $109.65	Facility		$33.88	$57.54	$109.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $57.54 / $100.00	Professional		$33.88	$57.54	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $32.36 / $38.90	Professional		$23.44	$32.36	$38.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $83.18 / $87.10	Facility		$60.26	$83.18	$87.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $56.23 / $60.26	Facility		$46.77	$56.23	$60.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $69.18 / $109.65	Professional		$39.81	$69.18	$109.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $446.68 / $851.14	Facility		$302.00	$446.68	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $60.26 / $100.00	Professional		$38.02	$60.26	$100.00
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $616.60 / $1,513.56	Facility		$416.87	$616.60	$1,513.56
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $57.54 / $102.33	Professional		$35.48	$57.54	$102.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $52.48 / $85.11	Professional		$45.71	$52.48	$85.11