Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $67.61 / $85.11	Professional		$33.11	$67.61	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $91.20 / $213.80	Facility		$57.54	$91.20	$213.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $89.13 / $181.97	Professional		$57.54	$89.13	$181.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $87.10 / $100.00	Facility		$85.11	$87.10	$100.00
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 $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $40.74 / $77.62	Professional		$31.62	$40.74	$77.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $109.65	Professional		$75.86	$75.86	$109.65