Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $69.18 / $81.28	Professional		$48.98	$69.18	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $56.23 / $114.82	Professional		$44.67	$56.23	$114.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $169.82 / $281.84	Facility		$56.23	$169.82	$281.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
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 $63.10 / $72.44 / $144.54	Facility		$63.10	$72.44	$144.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $100.00	Facility		$93.33	$93.33	$100.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $208.93	Professional		$100.00	$147.91	$208.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $173.78 / $331.13	Facility		$128.82	$173.78	$331.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $190.55	Professional		$95.50	$134.90	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $501.19 / $912.01	Facility		$354.81	$501.19	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $81.28 / $186.21	Professional		$57.54	$81.28	$186.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $91.20 / $151.36	Professional		$79.43	$91.20	$151.36