Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $20.89 / $43.65	Professional		$12.88	$20.89	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $26.92 / $35.48	Professional		$13.49	$26.92	$35.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $37.15 / $66.07	Facility		$21.88	$37.15	$66.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $39.81 / $70.79	Professional		$22.91	$39.81	$70.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $22.91 / $75.86	Professional		$18.62	$22.91	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $22.91 / $87.10	Facility		$22.91	$22.91	$87.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $20.89 / $28.84	Professional		$20.89	$20.89	$28.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $20.89 / $25.70	Professional		$19.50	$20.89	$25.70
United Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Facility		$22.39	$22.39	$22.39
United Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $22.91 / $46.77	Professional		$13.80	$22.91	$46.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $10.47 / $10.47	Professional		$10.47	$10.47	$10.47