Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $89.13	Professional		$52.48	$67.61	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $91.20 / $158.49	Facility		$57.54	$91.20	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $85.11 / $151.36	Professional		$57.54	$85.11	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $60.26	Professional		$50.12	$50.12	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $134.90 / $138.04	Facility		$109.65	$134.90	$138.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $134.90 / $199.53	Professional		$93.33	$134.90	$199.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $169.82	Professional		$85.11	$123.03	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $66.07 / $66.07	Facility		$47.86	$66.07	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $169.82	Professional		$69.18	$102.33	$169.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $77.62 / $138.04	Professional		$72.44	$77.62	$138.04