Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $89.13 / $245.47	Facility		$41.69	$89.13	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $37.15 / $81.28	Professional		$21.88	$37.15	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $93.33 / $134.90	Facility		$43.65	$93.33	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $46.77 / $61.66	Professional		$26.30	$46.77	$61.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $58.88 / $120.23	Facility		$41.69	$58.88	$120.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $58.88 / $128.82	Professional		$41.69	$58.88	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $44.67 / $75.86	Professional		$37.15	$44.67	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $79.43	Facility		$41.69	$41.69	$79.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $72.44 / $125.89	Facility		$41.69	$72.44	$125.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $50.12	Professional		$37.15	$37.15	$50.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $63.10 / $114.82	Facility		$43.65	$63.10	$114.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $37.15 / $48.98	Professional		$35.48	$37.15	$48.98
United Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $50.12 / $50.12	Facility		$41.69	$50.12	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $24.55 / $50.12	Professional		$17.38	$24.55	$50.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $41.69 / $75.86	Professional		$18.62	$41.69	$75.86