Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $81.28 / $234.42	Professional		$64.57	$81.28	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $144.54 / $251.19	Professional		$77.62	$144.54	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $204.17	Professional		$107.15	$154.88	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $46.77	Professional		$32.36	$33.11	$46.77
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Professional		$56.23	$56.23	$56.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $158.49 / $204.17	Professional		$97.72	$158.49	$204.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $181.97	Professional		$95.50	$134.90	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $204.17	Professional		$75.86	$125.89	$204.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $87.10 / $144.54	Professional		$75.86	$87.10	$144.54