Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $34.67 / $257.04	Professional		$28.84	$34.67	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Facility		$38.90	$38.90	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.90 / $51.29	Professional		$33.11	$38.90	$51.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $64.57	Facility		$60.26	$60.26	$64.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $64.57	Professional		$60.26	$60.26	$64.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $48.98 / $58.88	Professional		$38.90	$48.98	$58.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $63.10	Facility		$58.88	$58.88	$63.10
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $63.10	Professional		$58.88	$58.88	$63.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.90 / $52.48 / $79.43	Facility		$4.90	$52.48	$79.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.90 / $6.76 / $52.48	Professional		$4.90	$6.76	$52.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4.37 / $5.25 / $5.25	Professional		$4.37	$5.25	$5.25
United Facility/Professional Facility Modifier Low / Median / High Price $0.34 / $20.42 / $44.67	Facility		$0.34	$20.42	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $29.51 / $56.23	Professional		$28.84	$29.51	$56.23