Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $186.21 / $18,620.87	Facility		$97.72	$186.21	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $70.79 / $165.96	Professional		$42.66	$70.79	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $114.82	Facility		$75.86	$75.86	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $104.71 / $208.93	Professional		$63.10	$104.71	$208.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $117.49 / $208.93	Facility		$69.18	$117.49	$208.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $117.49 / $194.98	Professional		$69.18	$117.49	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $147.91 / $165.96	Facility		$95.50	$147.91	$165.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $107.15 / $112.20	Facility		$57.54	$107.15	$112.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $128.82 / $204.17	Professional		$70.79	$128.82	$204.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $575.44 / $1,096.48	Facility		$436.52	$575.44	$1,096.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $165.96	Professional		$70.79	$109.65	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $741.31 / $1,862.09	Facility		$501.19	$741.31	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $102.33 / $199.53	Professional		$64.57	$102.33	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $83.18 / $125.89	Professional		$44.67	$83.18	$125.89