Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $75.86 / $239.88	Facility		$54.95	$75.86	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.02 / $120.23	Professional		$25.12	$38.02	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $91.20 / $117.49	Facility		$34.67	$91.20	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $42.66 / $57.54	Professional		$18.62	$42.66	$57.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $54.95 / $107.15	Facility		$40.74	$54.95	$107.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $60.26 / $112.20	Professional		$40.74	$60.26	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $43.65 / $75.86	Professional		$35.48	$43.65	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $40.74 / $77.62	Facility		$40.74	$40.74	$77.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $70.79 / $123.03	Facility		$40.74	$70.79	$123.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $48.98	Professional		$36.31	$36.31	$48.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $61.66 / $112.20	Facility		$42.66	$61.66	$112.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $36.31 / $45.71	Professional		$34.67	$36.31	$45.71
United Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $48.98 / $48.98	Facility		$40.74	$48.98	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $24.55 / $77.62	Professional		$22.39	$24.55	$77.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $40.74 / $72.44	Professional		$18.20	$40.74	$72.44