Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $331.13	Facility		$50.12	$50.12	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $34.67 / $50.12	Professional		$28.18	$34.67	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $35.48	Professional		$35.48	$35.48	$35.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $60.26 / $154.88	Facility		$39.81	$60.26	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $56.23 / $109.65	Professional		$39.81	$56.23	$109.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $109.65	Professional		$32.36	$54.95	$109.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $85.11 / $85.11	Facility		$70.79	$85.11	$85.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $58.88	Facility		$57.54	$57.54	$58.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $91.20 / $123.03	Professional		$58.88	$91.20	$123.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $602.56 / $1,148.15	Facility		$457.09	$602.56	$1,148.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $79.43 / $97.72	Professional		$58.88	$79.43	$97.72
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $707.95 / $1,258.93	Facility		$524.81	$707.95	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $61.66 / $112.20	Professional		$42.66	$61.66	$112.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $346.74	Professional		$85.11	$85.11	$346.74