Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $112.20	Facility		$46.77	$46.77	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $61.66	Professional		$30.90	$46.77	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $114.82 / $181.97	Facility		$50.12	$114.82	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $114.82 / $181.97	Professional		$50.12	$114.82	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $70.79 / $87.10	Professional		$30.20	$70.79	$87.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $131.83 / $144.54	Facility		$67.61	$131.83	$144.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Professional		$67.61	$67.61	$67.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $95.50	Professional		$74.13	$74.13	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $36.31 / $69.18	Professional		$28.18	$36.31	$69.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $107.15	Professional		$60.26	$60.26	$107.15