Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $40.74 / $97.72	Facility		$40.74	$40.74	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.11 / $56.23	Professional		$25.70	$33.11	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Facility		$34.67	$34.67	$34.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $34.67	Professional		$25.70	$25.70	$34.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $83.18 / $173.78	Facility		$35.48	$83.18	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $72.44 / $128.82	Professional		$31.62	$72.44	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $61.66 / $75.86	Professional		$60.26	$61.66	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $60.26 / $63.10	Facility		$48.98	$60.26	$63.10
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $61.66 / $63.10	Professional		$54.95	$61.66	$63.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $89.13 / $131.83	Facility		$53.70	$89.13	$131.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $61.66	Professional		$51.29	$51.29	$61.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $53.70 / $69.18	Professional		$50.12	$53.70	$69.18
United Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $91.20 / $91.20	Facility		$27.54	$91.20	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $30.20 / $53.70	Professional		$25.70	$30.20	$53.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $53.70 / $93.33	Professional		$43.65	$53.70	$93.33