Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $100.00 / $128.82	Professional		$48.98	$100.00	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $134.90 / $316.23	Facility		$85.11	$134.90	$316.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $269.15	Professional		$85.11	$128.82	$269.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $120.23 / $123.03	Facility		$117.49	$120.23	$123.03
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 $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $60.26 / $114.82	Professional		$46.77	$60.26	$114.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $158.49	Professional		$107.15	$107.15	$158.49