Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $83.18 / $295.12	Facility		$44.67	$83.18	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $40.74 / $87.10	Professional		$28.18	$40.74	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $100.00 / $131.83	Facility		$25.12	$100.00	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $52.48 / $63.10	Professional		$23.44	$52.48	$63.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $54.95 / $138.04	Facility		$44.67	$54.95	$138.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $56.23 / $123.03	Professional		$44.67	$56.23	$123.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $85.11	Facility		$44.67	$44.67	$85.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $79.43 / $134.90	Facility		$44.67	$79.43	$134.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $40.74 / $53.70	Professional		$40.74	$40.74	$53.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $67.61 / $123.03	Facility		$46.77	$67.61	$123.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $40.74 / $53.70	Professional		$38.02	$40.74	$53.70
United Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $53.70 / $53.70	Facility		$44.67	$53.70	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $50.12	Professional		$19.05	$19.05	$50.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $44.67 / $81.28	Professional		$20.42	$44.67	$81.28