Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $151.36 / $204.17	Professional		$77.62	$151.36	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Professional		$91.20	$91.20	$91.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $213.80 / $501.19	Facility		$131.83	$213.80	$501.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $208.93 / $426.58	Professional		$134.90	$208.93	$426.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $204.17 / $208.93	Facility		$186.21	$204.17	$208.93
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 $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $95.50 / $181.97	Professional		$74.13	$95.50	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $251.19	Professional		$177.83	$177.83	$251.19