Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $57.54 / $104.71	Professional		$26.92	$57.54	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $83.18 / $194.98	Professional		$35.48	$83.18	$194.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $77.62 / $165.96	Facility		$35.48	$77.62	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $77.62 / $165.96	Professional		$34.67	$77.62	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $32.36 / $56.23	Professional		$20.42	$32.36	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $154.88 / $169.82	Facility		$104.71	$154.88	$169.82
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 $52.48 / $117.49 / $223.87	Professional		$52.48	$117.49	$223.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $97.72 / $186.21	Professional		$43.65	$97.72	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $83.18 / $162.18	Professional		$39.81	$83.18	$162.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $37.15 / $123.03	Professional		$22.91	$37.15	$123.03