Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $269.15 / $407.38	Facility		$52.48	$269.15	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.88 / $21.88	Professional		$12.02	$12.88	$21.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Facility		$22.39	$22.39	$22.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $22.39	Professional		$16.22	$16.22	$22.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $56.23 / $75.86	Facility		$41.69	$56.23	$75.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $56.23 / $75.86	Professional		$41.69	$56.23	$75.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $45.71 / $83.18	Professional		$37.15	$45.71	$83.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $28.18 / $32.36	Facility		$28.18	$28.18	$32.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $58.88 / $91.20	Facility		$38.90	$58.88	$91.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $56.23 / $85.11	Professional		$38.90	$56.23	$85.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $42.66 / $81.28	Facility		$35.48	$42.66	$81.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $37.15 / $43.65	Professional		$33.11	$37.15	$43.65
United Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $58.88 / $58.88	Facility		$14.13	$58.88	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $14.79 / $27.54	Professional		$12.88	$14.79	$27.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $37.15 / $66.07	Professional		$30.90	$37.15	$66.07