Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $125.89 / $457.09	Facility		$33.11	$125.89	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $56.23 / $120.23	Professional		$22.91	$56.23	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $70.79 / $162.18	Professional		$28.84	$70.79	$162.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $69.18 / $154.88	Facility		$28.18	$69.18	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $66.07 / $147.91	Professional		$25.70	$66.07	$147.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $47.86	Professional		$32.36	$33.11	$47.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $117.49 / $144.54	Facility		$97.72	$117.49	$144.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $93.33	Facility		$83.18	$83.18	$93.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $83.18 / $158.49	Professional		$32.36	$83.18	$158.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $70.79 / $144.54	Professional		$30.20	$70.79	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $67.61 / $154.88	Professional		$30.20	$67.61	$154.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $61.66 / $91.20	Professional		$21.38	$61.66	$91.20