Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $91.20 / $251.19	Facility		$42.66	$91.20	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $39.81 / $190.55	Professional		$28.18	$39.81	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $95.50 / $138.04	Facility		$44.67	$95.50	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $47.86 / $63.10	Professional		$26.92	$47.86	$63.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $60.26 / $131.83	Facility		$42.66	$60.26	$131.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $60.26 / $131.83	Professional		$42.66	$60.26	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $45.71 / $75.86	Professional		$38.02	$45.71	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $81.28	Facility		$42.66	$42.66	$81.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $74.13 / $128.82	Facility		$42.66	$74.13	$128.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $51.29	Professional		$38.90	$38.90	$51.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $64.57 / $117.49	Facility		$44.67	$64.57	$117.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $38.90 / $50.12	Professional		$36.31	$38.90	$50.12
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $51.29 / $51.29	Facility		$42.66	$51.29	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $25.12 / $51.29	Professional		$17.78	$25.12	$51.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $42.66 / $77.62	Professional		$19.50	$42.66	$77.62