Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $87.10 / $169.82	Facility		$61.66	$87.10	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $61.66 / $173.78	Professional		$30.90	$61.66	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $123.03	Facility		$102.33	$102.33	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $79.43 / $173.78	Professional		$39.81	$79.43	$173.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $79.43 / $162.18	Facility		$40.74	$79.43	$162.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $77.62 / $144.54	Professional		$40.74	$77.62	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $43.65	Professional		$32.36	$33.11	$43.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $120.23 / $131.83	Facility		$75.86	$120.23	$131.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $89.13	Facility		$81.28	$81.28	$89.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $89.13 / $162.18	Professional		$46.77	$89.13	$162.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $758.58 / $1,445.44	Facility		$501.19	$758.58	$1,445.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $83.18 / $144.54	Professional		$44.67	$83.18	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,047.13 / $2,238.72	Facility		$416.87	$1,047.13	$2,238.72
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $75.86 / $144.54	Professional		$41.69	$75.86	$144.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $57.54 / $100.00	Professional		$30.20	$57.54	$100.00