Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $81.28 / $524.81	Professional		$63.10	$81.28	$524.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Facility		$44.67	$44.67	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $44.67 / $112.20	Professional		$38.02	$44.67	$112.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $154.88	Facility		$125.89	$125.89	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $154.88	Professional		$125.89	$125.89	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $117.49 / $128.82	Professional		$93.33	$117.49	$128.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $125.89 / $147.91	Facility		$123.03	$125.89	$147.91
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $125.89 / $147.91	Professional		$123.03	$125.89	$147.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $112.20 / $165.96	Facility		$10.00	$112.20	$165.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $12.88 / $107.15	Professional		$10.00	$12.88	$107.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $12.59 / $12.59	Professional		$10.23	$12.59	$12.59
United Facility/Professional Facility Modifier Low / Median / High Price $0.85 / $43.65 / $93.33	Facility		$0.85	$43.65	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $63.10 / $123.03	Professional		$60.26	$63.10	$123.03