Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $38.90 / $53.70	Facility		$23.99	$38.90	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $21.88 / $38.90	Professional		$16.98	$21.88	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $34.67 / $60.26	Professional		$20.42	$34.67	$60.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $38.90 / $501.19	Facility		$23.99	$38.90	$501.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $34.67 / $50.12	Professional		$18.62	$34.67	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $32.36 / $33.11	Professional		$11.48	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $36.31 / $57.54	Facility		$30.20	$36.31	$57.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $25.70	Facility		$25.12	$25.12	$25.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $37.15 / $53.70	Professional		$25.12	$37.15	$53.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,513.56 / $2,884.03	Facility		$1,000.00	$1,513.56	$2,884.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $36.31 / $47.86	Professional		$26.30	$36.31	$47.86
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,412.54 / $2,511.89	Facility		$1,047.13	$1,412.54	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $32.36 / $52.48	Professional		$19.05	$32.36	$52.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $19.05 / $31.62	Professional		$16.60	$19.05	$31.62