Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $81.28 / $239.88	Facility		$44.67	$81.28	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $40.74 / $186.21	Professional		$39.81	$40.74	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $83.18	Facility		$38.02	$38.02	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $47.86	Professional		$39.81	$39.81	$47.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $50.12 / $100.00	Facility		$39.81	$50.12	$100.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $100.00	Professional		$39.81	$50.12	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $51.29 / $85.11	Facility		$40.74	$51.29	$85.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Professional		$53.70	$53.70	$53.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
United Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $52.48	Professional		$39.81	$39.81	$52.48