Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $114.82 / $144.54	Facility		$61.66	$114.82	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $48.98 / $120.23	Professional		$42.66	$48.98	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $93.33 / $138.04	Professional		$56.23	$93.33	$138.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $83.18 / $138.04	Professional		$60.26	$83.18	$138.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $104.71 / $107.15	Facility		$81.28	$104.71	$107.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $74.13 / $74.13	Facility		$69.18	$74.13	$74.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $104.71 / $154.88	Professional		$69.18	$104.71	$154.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $91.20 / $128.82	Professional		$69.18	$91.20	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $83.18 / $151.36	Professional		$57.54	$83.18	$151.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $50.12 / $89.13	Professional		$47.86	$50.12	$89.13