Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $77.62 / $173.78	Facility		$15.85	$77.62	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $14.13 / $20.89	Professional		$10.96	$14.13	$20.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $38.02 / $44.67	Facility		$17.78	$38.02	$44.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $17.38 / $27.54	Facility		$13.80	$17.38	$27.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $17.38 / $29.51	Professional		$13.80	$17.38	$29.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $19.05 / $30.20	Facility		$15.49	$19.05	$30.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $30.20 / $51.29	Facility		$17.38	$30.20	$51.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $15.49 / $20.42	Professional		$15.49	$15.49	$20.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $25.70 / $47.86	Facility		$18.20	$25.70	$47.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $15.49 / $19.50	Professional		$14.79	$15.49	$19.50
United Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $20.42 / $20.42	Facility		$17.38	$20.42	$20.42
United Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $7.24 / $19.50	Professional		$7.24	$7.24	$19.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $17.38 / $30.90	Professional		$7.76	$17.38	$30.90