Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $117.49 / $181.97	Facility		$87.10	$117.49	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $70.79 / $177.83	Professional		$45.71	$70.79	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $95.50	Facility		$57.54	$57.54	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $120.23 / $218.78	Professional		$70.79	$120.23	$218.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $107.15 / $204.17	Facility		$61.66	$107.15	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $107.15 / $186.21	Professional		$61.66	$107.15	$186.21
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 $89.13 / $128.82 / $158.49	Facility		$89.13	$128.82	$158.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $117.49 / $194.98	Professional		$66.07	$117.49	$194.98
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 $70.79 / $112.20 / $177.83	Professional		$70.79	$112.20	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $758.58 / $1,905.46	Facility		$549.54	$758.58	$1,905.46
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $97.72 / $190.55	Professional		$61.66	$97.72	$190.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $74.13 / $104.71	Professional		$40.74	$74.13	$104.71