Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $60.26	Facility		$25.12	$25.12	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $19.95 / $33.88	Professional		$15.14	$19.95	$33.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $21.38 / $21.38	Facility		$21.38	$21.38	$21.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $15.49 / $21.38	Professional		$15.49	$15.49	$21.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $51.29 / $107.15	Facility		$21.38	$51.29	$107.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $44.67 / $79.43	Professional		$21.38	$44.67	$79.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $38.02 / $64.57	Professional		$37.15	$38.02	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $36.31 / $38.90	Facility		$29.51	$36.31	$38.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $37.15 / $38.90	Professional		$33.88	$37.15	$38.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $54.95 / $79.43	Facility		$32.36	$54.95	$79.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $37.15	Professional		$30.90	$30.90	$37.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $32.36 / $41.69	Professional		$30.90	$32.36	$41.69
United Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $56.23 / $56.23	Facility		$16.98	$56.23	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $18.20 / $32.36	Professional		$15.85	$18.20	$32.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $32.36 / $57.54	Professional		$26.92	$32.36	$57.54