Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $75.86 / $229.09	Facility		$38.90	$75.86	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.31 / $117.49	Professional		$23.99	$36.31	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $87.10 / $114.82	Facility		$40.74	$87.10	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $41.69 / $53.70	Professional		$23.44	$41.69	$53.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $50.12 / $109.65	Facility		$38.90	$50.12	$109.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $53.70 / $114.82	Professional		$38.90	$53.70	$114.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $41.69 / $75.86	Professional		$34.67	$41.69	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $74.13	Facility		$38.90	$38.90	$74.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $69.18 / $117.49	Facility		$38.90	$69.18	$117.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $46.77	Professional		$35.48	$35.48	$46.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $58.88 / $107.15	Facility		$41.69	$58.88	$107.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $35.48 / $43.65	Professional		$33.11	$35.48	$43.65
United Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $46.77 / $46.77	Facility		$38.90	$46.77	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $20.42 / $46.77	Professional		$16.60	$20.42	$46.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $38.90 / $70.79	Professional		$17.78	$38.90	$70.79