Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $269.15 / $316.23	Facility		$138.04	$269.15	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $138.04 / $331.13	Professional		$91.20	$138.04	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $691.83 / $1,174.90	Facility		$89.13	$691.83	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $251.19 / $371.54	Professional		$147.91	$251.19	$371.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $269.15 / $1,122.02	Facility		$154.88	$269.15	$1,122.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $257.04 / $338.84	Professional		$154.88	$257.04	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $48.98	Professional		$32.36	$33.11	$48.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $234.42 / $295.12	Facility		$194.98	$234.42	$295.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $263.03 / $346.74	Professional		$162.18	$263.03	$346.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $691.83 / $1,348.96	Facility		$512.86	$691.83	$1,348.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $257.04 / $346.74	Professional		$165.96	$257.04	$346.74
United Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $891.25 / $1,584.89	Facility		$660.69	$891.25	$1,584.89
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $331.13	Professional		$107.15	$138.04	$331.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $229.09	Professional		$120.23	$162.18	$229.09