Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $81.28 / $512.86	Professional		$63.10	$81.28	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $81.28 / $107.15	Professional		$69.18	$81.28	$107.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $186.21	Facility		$123.03	$123.03	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $186.21	Professional		$123.03	$123.03	$186.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $154.88	Professional		$75.86	$125.89	$154.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $125.89 / $173.78	Facility		$117.49	$125.89	$173.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $154.88	Professional		$117.49	$117.49	$154.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $117.49 / $162.18	Facility		$9.77	$117.49	$162.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $13.49 / $114.82	Professional		$9.77	$13.49	$114.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $14.79 / $14.79	Professional		$12.30	$14.79	$14.79
United Facility/Professional Facility Modifier Low / Median / High Price $0.91 / $42.66 / $81.28	Facility		$0.91	$42.66	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $81.28 / $117.49	Professional		$61.66	$81.28	$117.49