Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $18.20 / $43.65	Facility		$18.20	$18.20	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $15.14 / $25.12	Professional		$10.96	$15.14	$25.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $15.85 / $15.85	Facility		$15.85	$15.85	$15.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $11.48 / $15.85	Professional		$11.48	$11.48	$15.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $38.02 / $77.62	Facility		$15.85	$38.02	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $33.11 / $58.88	Professional		$15.85	$33.11	$58.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $27.54 / $75.86	Professional		$26.92	$27.54	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $26.30 / $28.18	Facility		$21.38	$26.30	$28.18
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $26.92 / $28.18	Professional		$24.55	$26.92	$28.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $39.81 / $58.88	Facility		$23.99	$39.81	$58.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.39 / $26.92	Professional		$22.39	$22.39	$26.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $26.30 / $26.30	Facility		$26.30	$26.30	$26.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $23.44 / $30.20	Professional		$22.39	$23.44	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $41.69 / $41.69	Facility		$12.59	$41.69	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $13.49 / $23.99	Professional		$11.75	$13.49	$23.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $23.44 / $41.69	Professional		$19.50	$23.44	$41.69