Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $162.18	Facility		$67.61	$67.61	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $54.95 / $91.20	Professional		$41.69	$54.95	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $69.18	Professional		$51.29	$51.29	$69.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $134.90 / $288.40	Facility		$57.54	$134.90	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $120.23 / $213.80	Professional		$52.48	$120.23	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $100.00 / $102.33	Professional		$60.26	$100.00	$102.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $97.72 / $104.71	Facility		$79.43	$97.72	$104.71
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $100.00 / $104.71	Professional		$91.20	$100.00	$104.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $147.91 / $213.80	Facility		$87.10	$147.91	$213.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $100.00	Professional		$83.18	$83.18	$100.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $112.20	Professional		$83.18	$87.10	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $151.36 / $151.36	Facility		$45.71	$151.36	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $48.98 / $87.10	Professional		$42.66	$48.98	$87.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $70.79 / $154.88	Professional		$56.23	$70.79	$154.88