Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $10.00 / $23.99	Facility		$10.00	$10.00	$23.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $8.91 / $12.02	Professional		$5.01	$8.91	$12.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.00 / $10.00	Professional		$10.00	$10.00	$10.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $26.92 / $32.36	Facility		$15.85	$26.92	$32.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $26.92 / $34.67	Professional		$18.20	$26.92	$34.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $23.99 / $23.99	Facility		$19.95	$23.99	$23.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $16.22 / $16.60	Facility		$16.22	$16.22	$16.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $23.99 / $34.67	Professional		$16.60	$23.99	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $5.25 / $7.76 / $12.88	Professional		$5.25	$7.76	$12.88