Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $21.88 / $52.48	Professional		$10.96	$21.88	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $30.90 / $38.90	Professional		$7.24	$30.90	$38.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $30.20 / $74.13	Facility		$21.88	$30.20	$74.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $34.67 / $75.86	Professional		$23.44	$34.67	$75.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $27.54 / $75.86	Professional		$21.88	$27.54	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $48.98	Facility		$27.54	$27.54	$48.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $34.67	Professional		$25.12	$25.12	$34.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $25.12 / $30.90	Professional		$22.39	$25.12	$30.90
United Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $11.48 / $11.48	Facility		$11.48	$11.48	$11.48
United Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $21.38 / $56.23	Professional		$15.14	$21.38	$56.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $12.30 / $12.30	Professional		$12.30	$12.30	$12.30