Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $151.36	Professional		$87.10	$114.82	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $194.98 / $354.81	Professional		$109.65	$194.98	$354.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $131.83 / $234.42	Facility		$91.20	$131.83	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $131.83 / $239.88	Professional		$85.11	$131.83	$239.88
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 $58.88 / $60.26 / $218.78	Facility		$58.88	$60.26	$218.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Facility		$158.49	$158.49	$158.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $257.04 / $338.84	Professional		$158.49	$257.04	$338.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $309.03	Professional		$162.18	$223.87	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $138.04 / $275.42	Professional		$123.03	$138.04	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $74.13 / $123.03	Professional		$64.57	$74.13	$123.03