Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Facility		$25.12	$25.12	$25.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $26.30	Professional		$23.99	$23.99	$26.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $18.20 / $19.50	Facility		$18.20	$18.20	$19.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $19.50 / $22.39	Professional		$19.50	$19.50	$22.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $60.26 / $75.86	Professional		$30.20	$60.26	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $19.50 / $29.51	Facility		$19.50	$19.50	$29.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $22.91 / $25.12	Facility		$22.91	$22.91	$25.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.91 / $22.91	Professional		$22.39	$22.91	$22.91
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Professional		$25.12	$25.12	$25.12