Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $43.65 / $53.70	Professional		$21.88	$43.65	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $25.70	Professional		$25.70	$25.70	$25.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $57.54 / $141.25	Facility		$38.02	$57.54	$141.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $56.23 / $120.23	Professional		$38.02	$56.23	$120.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $53.70 / $67.61	Facility		$52.48	$53.70	$67.61
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 $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.92 / $51.29	Professional		$20.89	$26.92	$51.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $72.44	Professional		$46.77	$46.77	$72.44