Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $87.10 / $112.20	Facility		$53.70	$87.10	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $44.67 / $91.20	Professional		$38.02	$44.67	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $69.18 / $123.03	Professional		$45.71	$69.18	$123.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $81.28 / $104.71	Facility		$47.86	$81.28	$104.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $83.18 / $104.71	Professional		$50.12	$83.18	$104.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $81.28 / $83.18	Facility		$63.10	$81.28	$83.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $56.23	Facility		$54.95	$54.95	$56.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $85.11 / $120.23	Professional		$54.95	$85.11	$120.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $75.86 / $102.33	Professional		$48.98	$75.86	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $63.10 / $117.49	Professional		$44.67	$63.10	$117.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $46.77 / $75.86	Professional		$39.81	$46.77	$75.86