Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $257.04	Professional		$70.79	$109.65	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $173.78 / $309.03	Professional		$95.50	$173.78	$309.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $177.83 / $288.40	Facility		$107.15	$177.83	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $316.23	Professional		$109.65	$177.83	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $75.86 / $173.78	Professional		$40.74	$75.86	$173.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $213.80 / $223.87	Facility		$147.91	$213.80	$223.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $288.40	Professional		$114.82	$177.83	$288.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $239.88	Professional		$112.20	$169.82	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $165.96 / $309.03	Professional		$75.86	$165.96	$309.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $117.49	Professional		$61.66	$61.66	$117.49