Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $83.18 / $457.09	Facility		$38.02	$83.18	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $33.11 / $89.13	Professional		$20.89	$33.11	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $389.05 / $501.19	Facility		$257.04	$389.05	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $47.86 / $95.50	Professional		$26.30	$47.86	$95.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $61.66 / $165.96	Facility		$30.90	$61.66	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $53.70 / $83.18	Professional		$28.84	$53.70	$83.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $32.36 / $33.11	Professional		$15.85	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $57.54 / $63.10	Facility		$44.67	$57.54	$63.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $43.65	Facility		$42.66	$42.66	$43.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $69.18 / $91.20	Professional		$43.65	$69.18	$91.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $302.00 / $602.56	Facility		$213.80	$302.00	$602.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $63.10 / $89.13	Professional		$43.65	$63.10	$89.13
United Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $398.11 / $707.95	Facility		$295.12	$398.11	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.88 / $79.43	Professional		$25.70	$33.88	$79.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $37.15 / $60.26	Professional		$31.62	$37.15	$60.26