Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $125.89 / $18,620.87	Facility		$67.61	$125.89	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $57.54 / $234.42	Professional		$38.02	$57.54	$234.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $131.83 / $131.83	Professional	50	$123.03	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $120.23	Professional		$42.66	$72.44	$120.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $89.13 / $194.98	Facility		$66.07	$89.13	$194.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $87.10 / $131.83	Professional		$66.07	$87.10	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $32.36 / $33.88	Professional		$22.39	$32.36	$33.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $75.86 / $128.82	Facility		$63.10	$75.86	$128.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $52.48	Facility		$51.29	$51.29	$52.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $81.28 / $104.71	Professional		$48.98	$81.28	$104.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,122.02 / $2,137.96	Facility		$776.25	$1,122.02	$2,137.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $74.13 / $109.65	Professional		$52.48	$74.13	$109.65
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,548.82 / $3,548.13	Facility		$154.88	$1,548.82	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $70.79 / $112.20	Professional		$47.86	$70.79	$112.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $52.48 / $74.13	Professional		$26.30	$52.48	$74.13