Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $79.43	Facility		$33.11	$33.11	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $37.15 / $53.70	Professional		$25.12	$37.15	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.70 / $25.70	Professional		$21.38	$25.70	$25.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $91.20 / $141.25	Facility		$60.26	$91.20	$141.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $91.20 / $134.90	Professional		$60.26	$91.20	$134.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $45.71 / $64.57	Professional		$36.31	$45.71	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $60.26 / $61.66	Facility		$48.98	$60.26	$61.66
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $61.66 / $61.66	Professional		$53.70	$61.66	$61.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $51.29 / $112.20	Facility		$48.98	$51.29	$112.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $58.88	Professional		$48.98	$48.98	$58.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $69.18	Professional		$51.29	$51.29	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.30 / $50.12	Professional		$20.89	$26.30	$50.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $91.20	Professional		$51.29	$51.29	$91.20