Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $281.84 / $660.69	Facility		$12.88	$281.84	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $12.02 / $19.95	Professional		$10.96	$12.02	$19.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $11.22 / $23.99	Facility		$11.22	$11.22	$23.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $11.75 / $12.88	Professional		$11.75	$11.75	$12.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $23.99 / $380.19	Facility		$10.96	$23.99	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $23.44 / $33.11	Professional		$10.96	$23.44	$33.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $33.11 / $75.86	Professional		$11.75	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $11.75 / $17.78	Facility		$11.75	$11.75	$17.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.07 / $6.17 / $12.30	Facility		$4.07	$6.17	$12.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $12.30 / $13.49	Professional		$12.30	$12.30	$13.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $8.91 / $125.89	Facility		$8.13	$8.91	$125.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $131.83	Professional		$125.89	$125.89	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $125.89 / $125.89	Professional		$30.20	$125.89	$125.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04