Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $165.96 / $794.33	Facility		$85.11	$165.96	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $77.62 / $173.78	Professional		$56.23	$77.62	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $79.43	Facility		$47.86	$47.86	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $141.25 / $213.80	Professional		$89.13	$141.25	$213.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $151.36 / $537.03	Facility		$64.57	$151.36	$537.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $141.25 / $181.97	Professional		$64.57	$141.25	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $39.81	Professional		$32.36	$33.11	$39.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $134.90 / $144.54	Facility		$112.20	$134.90	$144.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $97.72	Facility		$93.33	$93.33	$97.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $162.18 / $208.93	Professional		$97.72	$162.18	$208.93
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 $95.50 / $138.04 / $186.21	Professional		$95.50	$138.04	$186.21
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 $72.44 / $109.65 / $199.53	Professional		$72.44	$109.65	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $100.00 / $141.25	Professional		$74.13	$100.00	$141.25