Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $218.78 / $269.15	Facility		$128.82	$218.78	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $109.65 / $295.12	Professional		$89.13	$109.65	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $295.12	Professional		$134.90	$199.53	$295.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Professional		$316.23	$316.23	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $194.98 / $204.17	Facility		$162.18	$194.98	$204.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $138.04	Facility		$134.90	$134.90	$138.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $223.87 / $288.40	Professional		$138.04	$223.87	$288.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $257.04	Professional		$134.90	$190.55	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,454.71 / $37,153.52	Facility		$707.95	$2,454.71	$37,153.52
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $162.18 / $288.40	Professional		$104.71	$162.18	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $162.18	Professional		$85.11	$117.49	$162.18