Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $151.36	Professional		$79.43	$93.33	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $97.72	Professional		$83.18	$83.18	$97.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $50.12 / $158.49	Professional		$16.22	$50.12	$158.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $158.49 / $177.83	Facility		$154.88	$158.49	$177.83
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $158.49 / $158.49	Professional		$154.88	$158.49	$158.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $154.88 / $218.78	Facility		$13.18	$154.88	$218.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $18.62 / $154.88	Professional		$13.18	$18.62	$154.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $1.00 / $54.95 / $125.89	Facility		$1.00	$54.95	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $131.83	Professional		$79.43	$79.43	$131.83