Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $93.33	Facility		$38.90	$38.90	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $32.36 / $52.48	Professional		$23.99	$32.36	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Facility		$43.65	$43.65	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $43.65	Professional		$32.36	$32.36	$43.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $79.43 / $165.96	Facility		$33.88	$79.43	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $69.18 / $123.03	Professional		$33.88	$69.18	$123.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $64.57	Professional		$58.88	$58.88	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $57.54 / $60.26	Facility		$46.77	$57.54	$60.26
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $58.88 / $60.26	Professional		$52.48	$58.88	$60.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $85.11 / $125.89	Facility		$51.29	$85.11	$125.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $58.88	Professional		$47.86	$47.86	$58.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $50.12 / $66.07	Professional		$47.86	$50.12	$66.07
United Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $87.10 / $87.10	Facility		$26.30	$87.10	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $28.84 / $51.29	Professional		$24.55	$28.84	$51.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $89.13	Professional		$41.69	$50.12	$89.13