Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $25.12 / $162.18	Professional		$19.05	$25.12	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $35.48	Facility		$26.92	$26.92	$35.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $26.92 / $35.48	Professional		$22.91	$26.92	$35.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $46.77	Facility		$38.90	$38.90	$46.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $46.77	Professional		$38.90	$38.90	$46.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $34.67 / $38.90	Professional		$31.62	$34.67	$38.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $40.74 / $44.67	Facility		$37.15	$40.74	$44.67
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $40.74 / $44.67	Professional		$37.15	$40.74	$44.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3.09 / $34.67 / $51.29	Facility		$3.09	$34.67	$51.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $4.27 / $34.67	Professional		$3.09	$4.27	$34.67
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $3.72 / $3.72	Professional		$3.09	$3.72	$3.72
United Facility/Professional Facility Modifier Low / Median / High Price $0.27 / $13.18 / $28.84	Facility		$0.27	$13.18	$28.84
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $19.50 / $37.15	Professional		$17.78	$19.50	$37.15