Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $912.01 / $1,995.26	Facility		$186.21	$912.01	$1,995.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $194.98	Professional		$120.23	$158.49	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $446.68 / $512.86	Facility		$208.93	$446.68	$512.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $199.53 / $323.59	Facility		$181.97	$199.53	$323.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $338.84	Professional		$158.49	$199.53	$338.84
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 $181.97 / $218.78 / $346.74	Facility		$181.97	$218.78	$346.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $346.74 / $602.56	Facility		$199.53	$346.74	$602.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $239.88	Professional		$181.97	$181.97	$239.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $302.00 / $524.81	Facility		$208.93	$302.00	$524.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $177.83 / $223.87	Professional		$169.82	$177.83	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $239.88 / $239.88	Facility		$199.53	$239.88	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $223.87	Professional		$83.18	$83.18	$223.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $199.53 / $363.08	Professional		$89.13	$199.53	$363.08