Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $43.65 / $173.78	Facility		$25.12	$43.65	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $19.95 / $87.10	Professional		$12.02	$19.95	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $37.15 / $123.03	Professional		$19.50	$37.15	$123.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $39.81 / $158.49	Facility		$18.20	$39.81	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $39.81 / $128.82	Professional		$21.38	$39.81	$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 $20.42 / $30.20 / $173.78	Facility		$20.42	$30.20	$173.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Professional		$31.62	$31.62	$31.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $21.38 / $24.55	Facility		$21.38	$21.38	$24.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $38.90 / $54.95	Professional		$24.55	$38.90	$54.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Facility		$21.88	$21.88	$21.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $34.67 / $50.12	Professional		$21.88	$34.67	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $26.92 / $109.65	Professional		$16.22	$26.92	$109.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $26.30 / $37.15	Professional		$19.50	$26.30	$37.15