Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $32.36 / $213.80	Professional		$23.99	$32.36	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $33.11	Facility		$33.11	$33.11	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.11 / $43.65	Professional		$28.18	$33.11	$43.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $66.07	Facility		$50.12	$50.12	$66.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $66.07	Professional		$50.12	$50.12	$66.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $60.26	Professional		$39.81	$50.12	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $63.10	Facility		$48.98	$48.98	$63.10
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $60.26	Professional		$48.98	$48.98	$60.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.07 / $45.71 / $66.07	Facility		$4.07	$45.71	$66.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.07 / $9.33 / $45.71	Professional		$4.07	$9.33	$45.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Facility		$47.86	$47.86	$47.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4.37 / $5.37 / $5.37	Professional		$4.37	$5.37	$5.37
United Facility/Professional Facility Modifier Low / Median / High Price $0.33 / $17.38 / $36.31	Facility		$0.33	$17.38	$36.31
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $29.51 / $48.98	Professional		$25.70	$29.51	$48.98