Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $575.44	Professional		$64.57	$85.11	$575.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $117.49	Facility		$91.20	$91.20	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $117.49	Professional		$77.62	$91.20	$117.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $169.82	Facility		$138.04	$138.04	$169.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $169.82	Professional		$138.04	$138.04	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $141.25	Professional		$75.86	$114.82	$141.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $134.90 / $165.96	Facility		$131.83	$134.90	$165.96
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $134.90 / $158.49	Professional		$131.83	$134.90	$158.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $123.03 / $181.97	Facility		$10.96	$123.03	$181.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $14.13 / $117.49	Professional		$10.96	$14.13	$117.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $13.80 / $13.80	Professional		$11.22	$13.80	$13.80
United Facility/Professional Facility Modifier Low / Median / High Price $0.89 / $47.86 / $100.00	Facility		$0.89	$47.86	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $75.86 / $131.83	Professional		$69.18	$75.86	$131.83