Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $338.84 / $831.76	Facility		$97.72	$338.84	$831.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $91.20 / $223.87	Professional		$47.86	$91.20	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $186.21	Facility		$154.88	$154.88	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $109.65 / $245.47	Professional		$56.23	$109.65	$245.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $112.20 / $218.78	Facility		$60.26	$112.20	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $112.20 / $208.93	Professional		$60.26	$112.20	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $61.66	Professional		$32.36	$33.11	$61.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $158.49 / $186.21	Facility		$107.15	$158.49	$186.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $125.89	Facility		$114.82	$114.82	$125.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $131.83 / $234.42	Professional		$74.13	$131.83	$234.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $446.68 / $851.14	Facility		$302.00	$446.68	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $117.49 / $204.17	Professional		$69.18	$117.49	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $616.60 / $1,513.56	Facility		$416.87	$616.60	$1,513.56
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $107.15 / $199.53	Professional		$61.66	$107.15	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $104.71 / $158.49	Professional		$54.95	$104.71	$158.49