Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $87.10 / $114.82	Professional		$41.69	$87.10	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Professional		$48.98	$48.98	$48.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $114.82 / $275.42	Facility		$72.44	$114.82	$275.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $229.09	Professional		$72.44	$109.65	$229.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $104.71 / $107.15	Facility		$100.00	$104.71	$107.15
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 $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $51.29 / $97.72	Professional		$39.81	$51.29	$97.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $138.04	Professional		$93.33	$93.33	$138.04