Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $169.82 / $218.78	Facility		$102.33	$169.82	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $85.11 / $204.17	Professional		$63.10	$85.11	$204.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $870.96 / $1,096.48	Facility		$575.44	$870.96	$1,096.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $134.90 / $251.19	Professional		$70.79	$134.90	$251.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $147.91 / $630.96	Facility		$89.13	$147.91	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $141.25 / $218.78	Professional		$75.86	$141.25	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $48.98	Professional		$32.36	$33.11	$48.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $154.88 / $169.82	Facility		$123.03	$154.88	$169.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $117.49	Facility		$112.20	$112.20	$117.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $234.42	Professional		$112.20	$186.21	$234.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $691.83 / $1,318.26	Facility		$478.63	$691.83	$1,318.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $169.82 / $239.88	Professional		$120.23	$169.82	$239.88
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $912.01 / $1,621.81	Facility		$676.08	$912.01	$1,621.81
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $95.50 / $213.80	Professional		$74.13	$95.50	$213.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $95.50 / $158.49	Professional		$83.18	$95.50	$158.49