Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $72.44 / $2,290.87	Facility		$30.20	$72.44	$2,290.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.84 / $36.31	Professional		$28.18	$28.84	$36.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $61.66	Facility		$30.90	$30.90	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Professional		$30.90	$30.90	$30.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $67.61 / $87.10	Facility		$28.84	$67.61	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $69.18 / $100.00	Professional		$36.31	$69.18	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $66.07	Facility		$33.88	$33.88	$66.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $33.88	Facility		$33.88	$33.88	$33.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $33.88	Professional		$33.88	$33.88	$33.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $33.88	Facility		$33.88	$33.88	$33.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $33.88	Professional		$33.88	$33.88	$33.88
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $36.31	Professional		$30.20	$30.20	$36.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $44.67 / $47.86	Professional		$33.88	$44.67	$47.86