Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $23.99 / $162.18	Professional		$19.05	$23.99	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $33.88	Facility		$25.70	$25.70	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $25.70 / $33.88	Professional		$21.88	$25.70	$33.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $51.29	Facility		$38.90	$38.90	$51.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $51.29	Professional		$38.90	$38.90	$51.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $38.90 / $42.66	Professional		$34.67	$38.90	$42.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $39.81 / $46.77	Facility		$38.02	$39.81	$46.77
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $38.02 / $46.77	Professional		$38.02	$38.02	$46.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3.09 / $35.48 / $51.29	Facility		$3.09	$35.48	$51.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $4.37 / $35.48	Professional		$3.09	$4.37	$35.48
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 $3.16 / $3.89 / $3.89	Professional		$3.16	$3.89	$3.89
United Facility/Professional Facility Modifier Low / Median / High Price $0.26 / $12.88 / $28.18	Facility		$0.26	$12.88	$28.18
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.50 / $36.31	Professional		$19.05	$19.50	$36.31