Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $22.91 / $56.23	Facility		$22.91	$22.91	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $26.92 / $56.23	Professional		$15.85	$26.92	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $16.98 / $16.98	Professional		$16.98	$16.98	$16.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $58.88 / $93.33	Facility		$34.67	$58.88	$93.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $61.66 / $93.33	Professional		$38.02	$61.66	$93.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $60.26	Professional		$32.36	$33.11	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $40.74 / $43.65	Facility		$40.74	$40.74	$43.65
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $75.86 / $109.65	Facility		$51.29	$75.86	$109.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $40.74	Professional		$34.67	$34.67	$40.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $46.77	Professional		$36.31	$36.31	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $17.78 / $33.88	Professional		$13.80	$17.78	$33.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $64.57	Professional		$36.31	$36.31	$64.57