Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $41.69 / $87.10	Professional		$30.20	$41.69	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $51.29 / $69.18	Professional		$25.12	$51.29	$69.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $77.62 / $147.91	Facility		$47.86	$77.62	$147.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $79.43 / $131.83	Professional		$50.12	$79.43	$131.83
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 $69.18 / $104.71 / $104.71	Facility		$69.18	$104.71	$104.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $138.04	Professional		$70.79	$109.65	$138.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $112.20	Professional		$64.57	$91.20	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $46.77 / $104.71	Professional		$30.20	$46.77	$104.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48