Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $43.65 / $128.82	Facility		$21.88	$43.65	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $19.95 / $89.13	Professional		$14.13	$19.95	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $48.98 / $64.57	Facility		$22.91	$48.98	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $23.44 / $30.20	Professional		$13.49	$23.44	$30.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $28.18 / $60.26	Facility		$21.88	$28.18	$60.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $29.51 / $64.57	Professional		$21.88	$29.51	$64.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $23.44 / $75.86	Professional		$19.50	$23.44	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $41.69	Facility		$21.88	$21.88	$41.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $38.02 / $66.07	Facility		$21.88	$38.02	$66.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $26.30	Professional		$19.95	$19.95	$26.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $33.11 / $60.26	Facility		$22.91	$33.11	$60.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $19.95 / $24.55	Professional		$18.62	$19.95	$24.55
United Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $26.30 / $26.30	Facility		$21.88	$26.30	$26.30
United Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $11.75 / $26.30	Professional		$9.12	$11.75	$26.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $21.88 / $39.81	Professional		$9.77	$21.88	$39.81