Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $26.30 / $31.62	Facility		$15.14	$26.30	$31.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $12.88 / $40.74	Professional		$10.00	$12.88	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $23.44 / $34.67	Professional		$15.85	$23.44	$34.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $27.54 / $1,230.27	Facility		$15.85	$27.54	$1,230.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $26.30 / $436.52	Professional		$15.14	$26.30	$436.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.76 / $13.49 / $33.11	Professional		$6.76	$13.49	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $22.91 / $23.99	Facility		$19.05	$22.91	$23.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $15.85 / $15.85	Facility		$15.85	$15.85	$15.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $26.92 / $33.88	Professional		$15.85	$26.92	$33.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,230.27 / $2,344.23	Facility		$851.14	$1,230.27	$2,344.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $22.91 / $30.20	Professional		$16.22	$22.91	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,659.59 / $3,548.13	Facility		$645.65	$1,659.59	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $19.50 / $33.88	Professional		$12.30	$19.50	$33.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $13.80 / $19.50	Professional		$10.23	$13.80	$19.50