Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $19.05 / $23.99	Professional		$15.14	$19.05	$23.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $21.88 / $38.90	Professional		$13.49	$21.88	$38.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $26.92 / $89.13	Facility		$6.31	$26.92	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $17.38 / $44.67	Professional		$6.31	$17.38	$44.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $10.47 / $19.05	Professional		$8.13	$10.47	$19.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $7.41 / $12.30 / $12.30	Facility		$7.41	$12.30	$12.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $97.72	Facility		$63.10	$63.10	$97.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $9.55 / $9.55	Professional		$9.55	$9.55	$9.55
United Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $138.04 / $190.55	Facility		$125.89	$138.04	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $32.36 / $58.88	Professional		$21.88	$32.36	$58.88