Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $64.57 / $204.17	Facility		$44.67	$64.57	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $36.31 / $134.90	Professional		$21.38	$36.31	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $69.18 / $87.10	Facility		$23.99	$69.18	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $33.11 / $43.65	Professional		$15.14	$33.11	$43.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $69.18 / $83.18	Facility		$40.74	$69.18	$83.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $69.18 / $89.13	Professional		$40.74	$69.18	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $61.66 / $67.61	Facility		$44.67	$61.66	$67.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $45.71	Facility		$43.65	$43.65	$45.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $72.44 / $100.00	Professional		$45.71	$72.44	$100.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Facility		$44.67	$44.67	$44.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $60.26 / $81.28	Professional		$44.67	$60.26	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $26.30 / $26.30	Facility		$26.30	$26.30	$26.30
United Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $20.89 / $52.48	Professional		$16.98	$20.89	$52.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $45.71 / $64.57	Professional		$33.88	$45.71	$64.57