Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $28.84 / $70.79	Facility		$28.84	$28.84	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $33.11 / $70.79	Professional		$18.20	$33.11	$70.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $34.67 / $34.67	Facility		$33.88	$34.67	$34.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $29.51 / $34.67	Professional		$21.38	$29.51	$34.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $61.66 / $107.15	Facility		$30.90	$61.66	$107.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $67.61 / $112.20	Professional		$30.90	$67.61	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $39.81 / $64.57	Professional		$36.31	$39.81	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $51.29 / $52.48	Facility		$46.77	$51.29	$52.48
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $52.48 / $52.48	Professional		$45.71	$52.48	$52.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $45.71 / $85.11	Facility		$43.65	$45.71	$85.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $57.54	Professional		$43.65	$43.65	$57.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $45.71 / $58.88	Professional		$42.66	$45.71	$58.88
United Facility/Professional Facility Modifier Low / Median / High Price $0.35 / $19.95 / $23.99	Facility		$0.35	$19.95	$23.99
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $22.39 / $42.66	Professional		$20.42	$22.39	$42.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $45.71 / $79.43	Professional		$37.15	$45.71	$79.43