Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $45.71 / $45.71	Facility		$26.92	$45.71	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $26.92 / $34.67	Professional		$10.00	$26.92	$34.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Professional		$46.77	$46.77	$46.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $104.71 / $181.97	Facility		$34.67	$104.71	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $75.86	Professional		$64.57	$64.57	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $89.13 / $89.13	Facility		$34.67	$89.13	$89.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $104.71 / $199.53	Facility		$79.43	$104.71	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $134.90 / $245.47	Facility		$100.00	$134.90	$245.47