Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $67.61 / $79.43	Professional		$30.90	$67.61	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Professional		$36.31	$36.31	$36.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $85.11 / $199.53	Facility		$52.48	$85.11	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $85.11 / $165.96	Professional		$53.70	$85.11	$165.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $85.11 / $89.13	Facility		$83.18	$85.11	$89.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,000.00 / $10,000.00 / $10,000.00	Facility		$10,000.00	$10,000.00	$10,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $10,000.00 / $10,000.00 / $10,000.00	Professional		$10,000.00	$10,000.00	$10,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $37.15 / $72.44	Professional		$29.51	$37.15	$72.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $100.00	Professional		$74.13	$74.13	$100.00