Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $117.49	Facility		$48.98	$48.98	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $85.11	Professional		$30.90	$44.67	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $52.48	Professional		$38.90	$38.90	$52.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $107.15 / $208.93	Facility		$44.67	$107.15	$208.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $93.33 / $165.96	Professional		$44.67	$93.33	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $56.23 / $64.57	Professional		$51.29	$56.23	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $72.44 / $74.13	Facility		$58.88	$72.44	$74.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $74.13 / $74.13	Professional		$66.07	$74.13	$74.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $107.15 / $158.49	Facility		$64.57	$107.15	$158.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $74.13	Professional		$61.66	$61.66	$74.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $64.57 / $83.18	Professional		$60.26	$64.57	$83.18
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $117.49 / $117.49	Facility		$35.48	$117.49	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.90 / $67.61	Professional		$33.11	$38.90	$67.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $112.20	Professional		$52.48	$64.57	$112.20