Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $275.42 / $407.38	Facility		$208.93	$275.42	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $398.11	Professional		$134.90	$190.55	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $302.00 / $524.81	Professional		$177.83	$302.00	$524.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $338.84 / $478.63	Facility		$239.88	$338.84	$478.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $338.84 / $501.19	Professional		$229.09	$338.84	$501.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $245.47 / $416.87	Facility		$204.17	$245.47	$416.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $269.15	Facility		$194.98	$194.98	$269.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $323.59 / $512.86	Professional		$194.98	$323.59	$512.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $354.81 / $489.78	Professional		$251.19	$354.81	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $489.78	Professional		$169.82	$223.87	$489.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $208.93	Professional		$109.65	$128.82	$208.93