Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $109.65 / $123.03	Facility		$53.70	$109.65	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $53.70 / $134.90	Professional		$39.81	$53.70	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $97.72 / $144.54	Professional		$64.57	$97.72	$144.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $100.00 / $123.03	Facility		$61.66	$100.00	$123.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $104.71 / $128.82	Professional		$61.66	$104.71	$128.82
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 $79.43 / $93.33 / $100.00	Facility		$79.43	$93.33	$100.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $114.82 / $144.54	Professional		$67.61	$114.82	$144.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $128.82	Professional		$67.61	$97.72	$128.82
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $660.69 / $6,165.95	Facility		$190.55	$660.69	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $81.28 / $144.54	Professional		$48.98	$81.28	$144.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $57.54 / $81.28	Professional		$42.66	$57.54	$81.28