Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $70.79 / $85.11	Facility		$42.66	$70.79	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.90 / $66.07	Professional		$25.12	$30.90	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $131.83 / $158.49	Professional		$61.66	$131.83	$158.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $43.65 / $269.15	Facility		$24.55	$43.65	$269.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $40.74 / $75.86	Professional		$24.55	$40.74	$75.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $32.36 / $33.11	Professional		$21.38	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $50.12 / $61.66	Facility		$35.48	$50.12	$61.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $40.74 / $43.65	Facility		$40.74	$40.74	$43.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $64.57 / $93.33	Professional		$43.65	$64.57	$93.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $891.25 / $1,698.24	Facility		$575.44	$891.25	$1,698.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $57.54 / $75.86	Professional		$41.69	$57.54	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $812.83 / $1,479.11	Facility		$616.60	$812.83	$1,479.11
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $75.86	Professional		$26.92	$41.69	$75.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $42.66 / $69.18	Professional		$37.15	$42.66	$69.18