Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $134.90 / $263.03	Facility		$91.20	$134.90	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $95.50 / $446.68	Professional		$63.10	$95.50	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $128.82 / $234.42	Professional		$75.86	$128.82	$234.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $144.54 / $204.17	Facility		$91.20	$144.54	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $144.54 / $199.53	Professional		$89.13	$144.54	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $144.54 / $154.88	Facility		$117.49	$144.54	$154.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $213.80	Professional		$102.33	$165.96	$213.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $186.21	Facility		$38.90	$38.90	$186.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $151.36 / $208.93	Professional		$104.71	$151.36	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $85.11 / $194.98	Professional		$77.62	$85.11	$194.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $89.13 / $147.91	Professional		$77.62	$89.13	$147.91