Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $131.83 / $234.42	Facility		$95.50	$131.83	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $87.10 / $218.78	Professional		$47.86	$87.10	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $151.36	Facility		$89.13	$89.13	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $141.25 / $275.42	Professional		$77.62	$141.25	$275.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $123.03 / $239.88	Facility		$69.18	$123.03	$239.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $123.03 / $223.87	Professional		$72.44	$123.03	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $162.18 / $181.97	Facility		$112.20	$162.18	$181.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $234.42	Professional		$70.79	$123.03	$234.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $562.34 / $1,071.52	Facility		$371.54	$562.34	$1,071.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $125.89 / $213.80	Professional		$74.13	$125.89	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $758.58 / $1,862.09	Facility		$537.03	$758.58	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $112.20 / $223.87	Professional		$63.10	$112.20	$223.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $87.10 / $128.82	Professional		$45.71	$87.10	$128.82