Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $64.57 / $75.86	Professional		$30.90	$64.57	$75.86
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 / $83.18 / $199.53	Facility		$52.48	$83.18	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $81.28 / $169.82	Professional		$53.70	$81.28	$169.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $77.62 / $79.43	Facility		$74.13	$77.62	$79.43
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 $69.18 / $69.18 / $100.00	Professional		$69.18	$69.18	$100.00