Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $50.12 / $1,000.00	Facility		$27.54	$50.12	$1,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $25.12 / $42.66	Professional		$23.99	$25.12	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $23.44 / $48.98	Facility		$23.44	$23.44	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $30.20	Professional		$25.12	$25.12	$30.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $32.36 / $69.18	Facility		$25.12	$32.36	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $32.36 / $63.10	Professional		$25.12	$32.36	$63.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $27.54 / $75.86	Professional		$25.12	$27.54	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $26.30 / $47.86	Facility		$25.12	$26.30	$47.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $36.31	Facility		$27.54	$27.54	$36.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $29.51	Professional		$27.54	$27.54	$29.51
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $33.11	Facility		$27.54	$27.54	$33.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $27.54 / $27.54	Professional		$25.12	$27.54	$27.54
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $28.18	Professional		$25.12	$25.12	$28.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $32.36	Professional		$25.12	$25.12	$32.36