Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $43.65 / $117.49	Facility		$27.54	$43.65	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $19.05 / $47.86	Professional		$14.13	$19.05	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $44.67 / $64.57	Facility		$20.89	$44.67	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $22.39 / $29.51	Professional		$12.59	$22.39	$29.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $28.18 / $57.54	Facility		$19.95	$28.18	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.18 / $61.66	Professional		$19.95	$28.18	$61.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $21.38 / $75.86	Professional		$17.78	$21.38	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $38.90	Facility		$19.95	$19.95	$38.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $35.48 / $60.26	Facility		$19.95	$35.48	$60.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $23.99	Professional		$18.20	$18.20	$23.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $30.20 / $54.95	Facility		$20.89	$30.20	$54.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $18.20 / $23.44	Professional		$16.98	$18.20	$23.44
United Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $23.99 / $23.99	Facility		$19.95	$23.99	$23.99
United Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $11.75 / $23.99	Professional		$8.51	$11.75	$23.99