Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $83.18	Facility		$77.62	$77.62	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $57.54 / $83.18	Professional		$47.86	$57.54	$83.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $67.61	Professional		$56.23	$56.23	$67.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $81.28 / $138.04	Facility		$53.70	$81.28	$138.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $77.62 / $128.82	Professional		$52.48	$77.62	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $123.03 / $125.89	Facility		$87.10	$123.03	$125.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $109.65 / $173.78	Professional		$81.28	$109.65	$173.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $151.36	Professional		$74.13	$104.71	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $91.20 / $141.25	Professional		$60.26	$91.20	$141.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $72.44 / $125.89	Professional		$66.07	$72.44	$125.89