Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $19.05	Facility		$19.05	$19.05	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $25.12 / $38.02	Professional		$19.05	$25.12	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $19.05	Professional		$19.05	$19.05	$19.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $28.84 / $48.98	Facility		$21.88	$28.84	$48.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.84 / $45.71	Professional		$21.88	$28.84	$45.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $79.43	Professional		$50.12	$50.12	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $45.71 / $45.71	Facility		$38.02	$45.71	$45.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Facility		$31.62	$31.62	$31.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $36.31 / $57.54	Professional		$31.62	$36.31	$57.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.90 / $57.54	Professional		$30.20	$38.90	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $38.90 / $93.33	Professional		$27.54	$38.90	$93.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $47.86	Professional		$25.12	$25.12	$47.86