Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $109.65 / $302.00	Facility		$51.29	$109.65	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $47.86 / $100.00	Professional		$28.18	$47.86	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $114.82 / $165.96	Facility		$53.70	$114.82	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $57.54 / $79.43	Professional		$32.36	$57.54	$79.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $72.44 / $147.91	Facility		$51.29	$72.44	$147.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $75.86 / $158.49	Professional		$51.29	$75.86	$158.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $97.72	Facility		$51.29	$51.29	$97.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $89.13 / $154.88	Facility		$51.29	$89.13	$154.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $61.66	Professional		$45.71	$45.71	$61.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $77.62 / $141.25	Facility		$53.70	$77.62	$141.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $45.71 / $60.26	Professional		$43.65	$45.71	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $61.66 / $61.66	Facility		$51.29	$61.66	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $30.20 / $61.66	Professional		$21.38	$30.20	$61.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $51.29 / $93.33	Professional		$22.91	$51.29	$93.33