Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $64.57	Facility		$26.92	$26.92	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $16.98 / $26.92	Professional		$12.88	$16.98	$26.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $27.54	Facility		$27.54	$27.54	$27.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $27.54	Professional		$19.95	$19.95	$27.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $58.88 / $83.18	Facility		$25.70	$58.88	$83.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $57.54 / $77.62	Professional		$25.70	$57.54	$77.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $43.65 / $53.70	Facility		$41.69	$43.65	$53.70
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $41.69	Professional		$41.69	$41.69	$41.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $53.70 / $75.86	Professional		$36.31	$53.70	$75.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $39.81 / $75.86	Facility		$33.11	$39.81	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $0.28 / $17.38 / $17.38	Facility		$0.28	$17.38	$17.38
United Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $18.20 / $29.51	Professional		$16.22	$18.20	$29.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $47.86 / $85.11	Professional		$39.81	$47.86	$85.11