Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $83.18 / $114.82	Facility		$66.07	$83.18	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $67.61 / $89.13	Professional		$58.88	$67.61	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $112.20 / $218.78	Facility		$67.61	$112.20	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $95.50 / $190.55	Professional		$64.57	$95.50	$190.55
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 $138.04 / $181.97 / $213.80	Facility		$138.04	$181.97	$213.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $144.54	Facility		$102.33	$102.33	$144.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $158.49 / $263.03	Professional		$102.33	$158.49	$263.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $223.87	Professional		$104.71	$144.54	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $213.80	Professional		$85.11	$117.49	$213.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $125.89 / $218.78	Professional		$114.82	$125.89	$218.78