Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $53.70 / $64.57	Professional		$38.02	$53.70	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $295.12 / $575.44	Facility		$102.33	$295.12	$575.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $70.79	Professional		$44.67	$50.12	$70.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $93.33 / $112.20	Facility		$40.74	$93.33	$112.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $77.62	Facility		$72.44	$72.44	$77.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $112.20 / $162.18	Professional		$77.62	$112.20	$162.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $281.84 / $524.81	Facility		$208.93	$281.84	$524.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $102.33 / $141.25	Professional		$64.57	$102.33	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $363.08 / $645.65	Facility		$269.15	$363.08	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $87.10 / $154.88	Professional		$57.54	$87.10	$154.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $56.23 / $79.43	Professional		$38.02	$56.23	$79.43