Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $194.98 / $436.52	Facility		$39.81	$194.98	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $34.67 / $83.18	Professional		$19.95	$34.67	$83.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $95.50 / $112.20	Facility		$44.67	$95.50	$112.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $43.65 / $69.18	Facility		$34.67	$43.65	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $43.65 / $74.13	Professional		$34.67	$43.65	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $47.86 / $75.86	Facility		$38.90	$47.86	$75.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $75.86 / $128.82	Facility		$43.65	$75.86	$128.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $52.48	Professional		$38.90	$38.90	$52.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $64.57 / $114.82	Facility		$45.71	$64.57	$114.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $38.90 / $48.98	Professional		$37.15	$38.90	$48.98
United Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $52.48 / $52.48	Facility		$43.65	$52.48	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $48.98	Professional		$18.20	$18.20	$48.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $43.65 / $77.62	Professional		$19.50	$43.65	$77.62