Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $173.78 / $18,620.87	Facility		$120.23	$173.78	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $346.74	Professional		$64.57	$89.13	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $120.23 / $234.42	Professional		$72.44	$120.23	$234.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $107.15 / $199.53	Facility		$45.71	$107.15	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $107.15 / $190.55	Professional		$45.71	$107.15	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $61.66	Professional		$32.36	$33.11	$61.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $147.91 / $154.88	Facility		$117.49	$147.91	$154.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $100.00 / $104.71	Facility		$87.10	$100.00	$104.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $147.91 / $194.98	Professional		$89.13	$147.91	$194.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $831.76 / $1,584.89	Facility		$549.54	$831.76	$1,584.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $144.54 / $204.17	Professional		$102.33	$144.54	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,096.48 / $2,511.89	Facility		$154.88	$1,096.48	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $194.98	Professional		$79.43	$107.15	$194.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $93.33 / $154.88	Professional		$54.95	$93.33	$154.88