Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $309.03 / $18,620.87	Facility		$128.82	$309.03	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $147.91 / $537.03	Professional		$70.79	$147.91	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $177.83	Facility		$117.49	$117.49	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $165.96 / $316.23	Professional		$87.10	$165.96	$316.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $177.83 / $331.13	Facility		$104.71	$177.83	$331.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $173.78 / $309.03	Professional		$104.71	$173.78	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $239.88 / $245.47	Facility		$169.82	$239.88	$245.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $165.96 / $169.82	Facility		$93.33	$165.96	$169.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $173.78 / $309.03	Professional		$93.33	$173.78	$309.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $691.83 / $1,318.26	Facility		$524.81	$691.83	$1,318.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $251.19	Professional		$107.15	$165.96	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $870.96 / $1,905.46	Facility		$501.19	$870.96	$1,905.46
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $154.88 / $309.03	Professional		$89.13	$154.88	$309.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $107.15 / $173.78	Professional		$56.23	$107.15	$173.78