Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $208.93 / $436.52	Facility		$107.15	$208.93	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $436.52	Professional		$72.44	$107.15	$436.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $154.88 / $275.42	Professional		$89.13	$154.88	$275.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $169.82 / $234.42	Facility		$109.65	$169.82	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $169.82 / $234.42	Professional		$109.65	$169.82	$234.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $169.82 / $186.21	Facility		$141.25	$169.82	$186.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $194.98 / $251.19	Professional		$120.23	$194.98	$251.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $288.40	Facility		$57.54	$57.54	$288.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $177.83 / $245.47	Professional		$120.23	$177.83	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $102.33 / $229.09	Professional		$91.20	$102.33	$229.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $104.71 / $173.78	Professional		$91.20	$104.71	$173.78