Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $45.71 / $165.96	Facility		$19.95	$45.71	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $18.20 / $38.90	Professional		$14.13	$18.20	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $44.67 / $72.44	Facility		$20.89	$44.67	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $23.44 / $31.62	Professional		$13.49	$23.44	$31.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $28.18 / $57.54	Facility		$19.95	$28.18	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.18 / $61.66	Professional		$19.95	$28.18	$61.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $17.78 / $75.86	Professional		$12.88	$17.78	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $42.66	Facility		$19.95	$19.95	$42.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $35.48 / $60.26	Facility		$19.95	$35.48	$60.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $23.99	Professional		$18.20	$18.20	$23.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $30.20 / $54.95	Facility		$20.89	$30.20	$54.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $18.20 / $22.39	Professional		$16.98	$18.20	$22.39
United Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $23.99 / $23.99	Facility		$19.95	$23.99	$23.99
United Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $11.48 / $22.39	Professional		$8.51	$11.48	$22.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $9.12 / $36.31	Professional		$9.12	$9.12	$36.31