Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $47.86 / $169.82	Facility		$29.51	$47.86	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $25.12 / $56.23	Professional		$16.98	$25.12	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $61.66 / $75.86	Facility		$26.92	$61.66	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $30.90 / $39.81	Professional		$14.45	$30.90	$39.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $34.67 / $75.86	Facility		$28.84	$34.67	$75.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $36.31 / $77.62	Professional		$28.84	$36.31	$77.62
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 $29.51 / $29.51 / $54.95	Facility		$29.51	$29.51	$54.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $51.29 / $87.10	Facility		$29.51	$51.29	$87.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $26.30 / $34.67	Professional		$26.30	$26.30	$34.67
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $43.65 / $81.28	Facility		$30.90	$43.65	$81.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $26.30 / $32.36	Professional		$25.12	$26.30	$32.36
United Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $34.67 / $34.67	Facility		$29.51	$34.67	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $12.30 / $32.36	Professional		$12.30	$12.30	$32.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $29.51 / $52.48	Professional		$13.18	$29.51	$52.48