Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $120.23	Facility		$50.12	$50.12	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $45.71 / $77.62	Professional		$34.67	$45.71	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $48.98	Professional		$35.48	$35.48	$48.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $123.03 / $223.87	Facility		$48.98	$123.03	$223.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $100.00 / $181.97	Professional		$48.98	$100.00	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $60.26 / $75.86	Professional		$53.70	$60.26	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $75.86 / $104.71	Facility		$61.66	$75.86	$104.71
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $77.62 / $104.71	Professional		$66.07	$77.62	$104.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $114.82 / $165.96	Facility		$67.61	$114.82	$165.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $77.62	Professional		$64.57	$64.57	$77.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $87.10	Professional		$67.61	$67.61	$87.10
United Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $125.89 / $125.89	Facility		$39.81	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $52.48 / $74.13	Professional		$36.31	$52.48	$74.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $56.23 / $120.23	Professional		$53.70	$56.23	$120.23