Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $29.51 / $81.28	Facility		$19.95	$29.51	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $15.85 / $36.31	Professional		$10.96	$15.85	$36.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7.76 / $7.76 / $12.88	Facility		$7.76	$7.76	$12.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $26.92 / $41.69	Professional		$18.20	$26.92	$41.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $27.54 / $173.78	Facility		$13.49	$27.54	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $26.92 / $36.31	Professional		$14.45	$26.92	$36.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $28.18 / $30.90	Facility		$21.88	$28.18	$30.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $20.42	Facility		$19.95	$19.95	$20.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $28.84 / $39.81	Professional		$16.98	$28.84	$39.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $575.44 / $1,071.52	Facility		$426.58	$575.44	$1,071.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $25.70 / $37.15	Professional		$17.38	$25.70	$37.15
United Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $758.58 / $1,905.46	Facility		$549.54	$758.58	$1,905.46
United Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $24.55 / $41.69	Professional		$14.79	$24.55	$41.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $19.95 / $28.18	Professional		$14.79	$19.95	$28.18