Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $47.86 / $57.54	Professional		$23.99	$47.86	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Professional		$28.84	$28.84	$28.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $64.57 / $158.49	Facility		$41.69	$64.57	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $63.10 / $131.83	Professional		$41.69	$63.10	$131.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $60.26	Facility		$57.54	$57.54	$60.26
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 $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $29.51 / $56.23	Professional		$23.44	$29.51	$56.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $79.43	Professional		$51.29	$51.29	$79.43