Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $389.05 / $954.99	Facility		$263.03	$389.05	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $181.97 / $501.19	Professional		$123.03	$181.97	$501.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $831.76 / $1,023.29	Facility		$346.74	$831.76	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $245.47 / $489.78	Professional		$117.49	$245.47	$489.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $275.42 / $630.96	Facility		$151.36	$275.42	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $295.12 / $416.87	Professional		$147.91	$295.12	$416.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $302.00 / $316.23	Facility		$208.93	$302.00	$316.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $213.80 / $213.80	Facility		$199.53	$213.80	$213.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $346.74 / $446.68	Professional		$213.80	$346.74	$446.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $676.08 / $1,318.26	Facility		$478.63	$676.08	$1,318.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $316.23 / $436.52	Professional		$218.78	$316.23	$436.52
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 $114.82 / $165.96 / $398.11	Professional		$114.82	$165.96	$398.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $190.55 / $316.23	Professional		$165.96	$190.55	$316.23