Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $478.63	Professional		$57.54	$72.44	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $77.62 / $102.33	Professional		$66.07	$77.62	$102.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $141.25	Facility		$114.82	$114.82	$141.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $141.25	Professional		$114.82	$114.82	$141.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $117.49	Professional		$85.11	$107.15	$117.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $117.49 / $134.90	Facility		$112.20	$117.49	$134.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $131.83	Professional		$112.20	$117.49	$131.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $102.33 / $151.36	Facility		$9.33	$102.33	$151.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $12.88 / $102.33	Professional		$9.33	$12.88	$102.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $11.48 / $11.48	Professional		$9.33	$11.48	$11.48
United Facility/Professional Facility Modifier Low / Median / High Price $0.78 / $39.81 / $85.11	Facility		$0.78	$39.81	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $112.20	Professional		$54.95	$57.54	$112.20