Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $85.11 / $309.03	Facility		$53.70	$85.11	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $48.98 / $104.71	Professional		$28.84	$48.98	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $117.49 / $138.04	Facility		$44.67	$117.49	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $54.95 / $72.44	Professional		$24.55	$54.95	$72.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $64.57 / $138.04	Facility		$48.98	$64.57	$138.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $67.61 / $141.25	Professional		$48.98	$67.61	$141.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $56.23 / $75.86	Professional		$46.77	$56.23	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $102.33	Facility		$53.70	$53.70	$102.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $93.33 / $162.18	Facility		$53.70	$93.33	$162.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $64.57	Professional		$47.86	$47.86	$64.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $79.43 / $147.91	Facility		$56.23	$79.43	$147.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $47.86 / $60.26	Professional		$45.71	$47.86	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $64.57 / $64.57	Facility		$53.70	$64.57	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $22.39 / $60.26	Professional		$20.42	$22.39	$60.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $53.70 / $95.50	Professional		$23.99	$53.70	$95.50