Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $109.65	Professional		$67.61	$81.28	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $85.11 / $181.97	Professional		$52.48	$85.11	$181.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $85.11 / $123.03	Facility		$69.18	$85.11	$123.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $85.11 / $123.03	Professional		$69.18	$85.11	$123.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $60.26	Professional		$44.67	$50.12	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $162.18 / $165.96	Facility		$134.90	$162.18	$165.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $154.88 / $234.42	Professional		$97.72	$154.88	$234.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $112.20 / $162.18	Professional		$100.00	$112.20	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $128.82 / $234.42	Professional		$87.10	$128.82	$234.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62