Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $194.98 / $426.58	Facility		$107.15	$194.98	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $102.33 / $389.05	Professional		$75.86	$102.33	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $181.97 / $281.84	Professional		$120.23	$181.97	$281.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $79.43 / $199.53	Facility		$48.98	$79.43	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $79.43 / $208.93	Professional		$48.98	$79.43	$208.93
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 $30.20 / $31.62 / $158.49	Facility		$30.20	$31.62	$158.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $120.23	Facility		$117.49	$117.49	$120.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $199.53 / $251.19	Professional		$120.23	$199.53	$251.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $169.82 / $223.87	Professional		$120.23	$169.82	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $93.33 / $229.09	Professional		$85.11	$93.33	$229.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $45.71 / $63.10	Professional		$33.88	$45.71	$63.10