Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $151.36 / $338.84	Facility		$30.90	$151.36	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.92 / $41.69	Professional		$21.88	$26.92	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $75.86 / $87.10	Facility		$35.48	$75.86	$87.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $33.88 / $53.70	Facility		$26.92	$33.88	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.88 / $57.54	Professional		$26.92	$33.88	$57.54
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 $30.20 / $37.15 / $58.88	Facility		$30.20	$37.15	$58.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $58.88 / $102.33	Facility		$33.88	$58.88	$102.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $40.74	Professional		$30.20	$30.20	$40.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $51.29 / $93.33	Facility		$35.48	$51.29	$93.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $30.20 / $38.02	Professional		$28.84	$30.20	$38.02
United Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $40.74 / $40.74	Facility		$33.88	$40.74	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $38.02	Professional		$14.13	$14.13	$38.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $33.88 / $60.26	Professional		$15.14	$33.88	$60.26