Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $181.97 / $18,620.87	Facility		$89.13	$181.97	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $77.62 / $186.21	Professional		$42.66	$77.62	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $107.15	Facility		$64.57	$64.57	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $128.82 / $229.09	Professional		$74.13	$128.82	$229.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $114.82 / $288.40	Facility		$67.61	$114.82	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $112.20 / $199.53	Professional		$69.18	$112.20	$199.53
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 $104.71 / $147.91 / $165.96	Facility		$104.71	$147.91	$165.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $112.20	Facility		$109.65	$109.65	$112.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $120.23 / $208.93	Professional		$67.61	$120.23	$208.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $912.01 / $1,737.80	Facility		$660.69	$912.01	$1,737.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $190.55	Professional		$72.44	$114.82	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,148.15 / $2,398.83	Facility		$645.65	$1,148.15	$2,398.83
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $104.71 / $204.17	Professional		$63.10	$104.71	$204.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $77.62 / $120.23	Professional		$40.74	$77.62	$120.23