Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $398.11	Professional		$87.10	$87.10	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.02 / $194.98	Professional		$12.02	$12.02	$194.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Professional		$812.83	$812.83	$812.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $70.79	Professional		$44.67	$50.12	$70.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $398.11 / $426.58	Facility		$281.84	$398.11	$426.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $43.65 / $57.54	Professional		$37.15	$43.65	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $151.36 / $380.19	Professional		$144.54	$151.36	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18