Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $66.07 / $380.19	Facility		$48.98	$66.07	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $40.74 / $69.18	Professional		$33.11	$40.74	$69.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $61.66	Professional		$52.48	$52.48	$61.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $109.65 / $218.78	Facility		$43.65	$109.65	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $97.72 / $162.18	Professional		$43.65	$97.72	$162.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $74.13 / $81.28	Professional		$66.07	$74.13	$81.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $75.86 / $79.43	Facility		$74.13	$75.86	$79.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $114.82 / $177.83	Facility		$87.10	$114.82	$177.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $74.13 / $87.10	Professional		$70.79	$74.13	$87.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $85.11	Professional		$66.07	$66.07	$85.11
United Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $114.82 / $114.82	Facility		$45.71	$114.82	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $66.07	Professional		$33.11	$46.77	$66.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $66.07 / $117.49	Professional		$54.95	$66.07	$117.49