Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $91.20 / $125.89	Facility		$50.12	$91.20	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $67.61	Professional		$52.48	$52.48	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $53.70 / $102.33	Facility		$50.12	$53.70	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $60.26	Professional		$53.70	$53.70	$60.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $54.95 / $128.82	Facility		$53.70	$54.95	$128.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $53.70 / $109.65	Professional		$46.77	$53.70	$109.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $58.88 / $75.86	Professional		$52.48	$58.88	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $57.54 / $100.00	Facility		$52.48	$57.54	$100.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $57.54 / $138.04	Facility		$43.65	$57.54	$138.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $64.57	Professional		$54.95	$54.95	$64.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $63.10 / $154.88	Facility		$39.81	$63.10	$154.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $58.88 / $66.07	Professional		$53.70	$58.88	$66.07
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $58.88	Professional		$53.70	$53.70	$58.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $69.18	Professional		$53.70	$53.70	$69.18