Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $112.20 / $229.09	Facility		$81.28	$112.20	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $81.28 / $169.82	Professional		$39.81	$81.28	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $104.71 / $239.88	Professional		$51.29	$104.71	$239.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $104.71 / $213.80	Facility		$52.48	$104.71	$213.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $102.33 / $194.98	Professional		$52.48	$102.33	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $47.86	Professional		$32.36	$32.36	$47.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $162.18 / $177.83	Facility		$112.20	$162.18	$177.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $120.23	Facility		$112.20	$112.20	$120.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $120.23 / $223.87	Professional		$63.10	$120.23	$223.87
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 $57.54 / $114.82 / $199.53	Professional		$57.54	$114.82	$199.53
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 $53.70 / $100.00 / $199.53	Professional		$53.70	$100.00	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $72.44 / $141.25	Professional		$38.90	$72.44	$141.25