Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $18.20 / $42.66	Facility		$18.20	$18.20	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $14.79 / $26.92	Professional		$10.96	$14.79	$26.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $18.62 / $18.62	Facility		$18.62	$18.62	$18.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $13.49 / $18.62	Professional		$13.49	$13.49	$18.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $37.15 / $77.62	Facility		$15.49	$37.15	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $32.36 / $56.23	Professional		$15.49	$32.36	$56.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $25.70 / $60.26	Professional		$23.44	$25.70	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $26.30 / $27.54	Facility		$21.38	$26.30	$27.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $26.92 / $27.54	Professional		$23.99	$26.92	$27.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $39.81 / $57.54	Facility		$23.44	$39.81	$57.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.39 / $26.92	Professional		$22.39	$22.39	$26.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $26.30 / $26.30	Facility		$26.30	$26.30	$26.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $23.44 / $30.20	Professional		$22.39	$23.44	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $39.81 / $39.81	Facility		$12.30	$39.81	$39.81
United Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $13.18 / $23.44	Professional		$11.48	$13.18	$23.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $23.44 / $41.69	Professional		$19.05	$23.44	$41.69