Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $154.88 / $213.80	Facility		$95.50	$154.88	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $79.43 / $229.09	Professional		$33.88	$79.43	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $162.18 / $257.04	Professional		$75.86	$162.18	$257.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $151.36 / $204.17	Facility		$53.70	$151.36	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $154.88 / $208.93	Professional		$58.88	$154.88	$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 $72.44 / $144.54 / $162.18	Facility		$72.44	$144.54	$162.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $109.65	Facility		$107.15	$107.15	$109.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $234.42	Professional		$109.65	$181.97	$234.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $151.36 / $208.93	Professional		$85.11	$151.36	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $77.62 / $204.17	Professional		$44.67	$77.62	$204.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $162.18	Professional		$85.11	$114.82	$162.18