Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $87.10 / $100.00	Professional		$42.66	$87.10	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Professional		$51.29	$51.29	$51.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $117.49 / $281.84	Facility		$74.13	$117.49	$281.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $117.49 / $234.42	Professional		$75.86	$117.49	$234.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $114.82 / $117.49	Facility		$107.15	$114.82	$117.49
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 $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $100.00	Professional		$41.69	$52.48	$100.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $141.25	Professional		$100.00	$100.00	$141.25