Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $95.50	Facility		$39.81	$39.81	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.11 / $63.10	Professional		$25.70	$33.11	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $26.92 / $36.31	Professional		$26.92	$26.92	$36.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $81.28 / $169.82	Facility		$34.67	$81.28	$169.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $70.79 / $125.89	Professional		$34.67	$70.79	$125.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $64.57	Professional		$60.26	$60.26	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $58.88 / $61.66	Facility		$47.86	$58.88	$61.66
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $60.26 / $61.66	Professional		$53.70	$60.26	$61.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $87.10 / $128.82	Facility		$52.48	$87.10	$128.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $60.26	Professional		$50.12	$50.12	$60.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $51.29 / $67.61	Professional		$48.98	$51.29	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $89.13 / $89.13	Facility		$26.92	$89.13	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $29.51 / $52.48	Professional		$25.12	$29.51	$52.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $51.29 / $91.20	Professional		$42.66	$51.29	$91.20