Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $63.10 / $87.10	Facility		$38.90	$63.10	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.11 / $81.28	Professional		$22.91	$33.11	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $309.03 / $371.54	Facility		$128.82	$309.03	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $50.12 / $97.72	Professional		$27.54	$50.12	$97.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $63.10 / $165.96	Facility		$33.11	$63.10	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $57.54 / $87.10	Professional		$30.20	$57.54	$87.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $32.36 / $33.11	Professional		$15.85	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $60.26 / $66.07	Facility		$43.65	$60.26	$66.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $45.71	Facility		$44.67	$44.67	$45.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $72.44 / $95.50	Professional		$45.71	$72.44	$95.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $251.19 / $489.78	Facility		$158.49	$251.19	$489.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $66.07 / $93.33	Professional		$45.71	$66.07	$93.33
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $331.13 / $588.84	Facility		$245.47	$331.13	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $36.31 / $83.18	Professional		$26.92	$36.31	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.02 / $63.10	Professional		$33.11	$38.02	$63.10