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 / $39.81 / $85.11	Professional		$30.90	$39.81	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $41.69	Facility		$41.69	$41.69	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $41.69	Professional		$30.90	$30.90	$41.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $100.00 / $208.93	Facility		$42.66	$100.00	$208.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $87.10 / $154.88	Professional		$38.02	$87.10	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $72.44 / $74.13	Professional		$60.26	$72.44	$74.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $70.79 / $75.86	Facility		$57.54	$70.79	$75.86
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $72.44 / $75.86	Professional		$66.07	$72.44	$75.86
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 $60.26 / $60.26 / $72.44	Professional		$60.26	$60.26	$72.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Facility		$70.79	$70.79	$70.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $63.10 / $81.28	Professional		$60.26	$63.10	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $109.65 / $109.65	Facility		$33.11	$109.65	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $36.31 / $64.57	Professional		$30.90	$36.31	$64.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $112.20	Professional		$52.48	$63.10	$112.20