Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $33.11 / $41.69	Professional		$15.85	$33.11	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $19.50 / $19.50	Professional		$19.50	$19.50	$19.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $48.98 / $109.65	Facility		$28.84	$48.98	$109.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $91.20	Professional		$28.84	$46.77	$91.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $50.12 / $51.29	Facility		$48.98	$50.12	$51.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Professional		$46.77	$46.77	$46.77
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 $66.07 / $66.07 / $66.07	Facility		$66.07	$66.07	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $20.42 / $38.90	Professional		$15.85	$20.42	$38.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $54.95	Professional		$44.67	$44.67	$54.95