Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $53.70 / $64.57	Professional		$26.92	$53.70	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $32.36	Professional		$32.36	$32.36	$32.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $75.86 / $177.83	Facility		$46.77	$75.86	$177.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $75.86 / $151.36	Professional		$47.86	$75.86	$151.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $77.62	Facility		$75.86	$75.86	$77.62
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 $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.11 / $64.57	Professional		$26.30	$33.11	$64.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $89.13	Professional		$66.07	$66.07	$89.13