Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $645.65 / $1,737.80	Facility		$295.12	$645.65	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $575.44	Professional		$199.53	$257.04	$575.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $660.69 / $870.96	Facility		$263.03	$660.69	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $316.23 / $407.38	Professional		$141.25	$316.23	$407.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $371.54 / $912.01	Facility		$281.84	$371.54	$912.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $371.54 / $794.33	Professional		$281.84	$371.54	$794.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $446.68	Facility		$295.12	$295.12	$446.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $512.86 / $891.25	Facility		$295.12	$512.86	$891.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $354.81	Professional		$269.15	$269.15	$354.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $446.68 / $812.83	Facility		$309.03	$446.68	$812.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $269.15 / $354.81	Professional		$251.19	$269.15	$354.81
United Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $354.81 / $354.81	Facility		$295.12	$354.81	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $331.13	Professional		$123.03	$123.03	$331.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $295.12 / $537.03	Professional		$131.83	$295.12	$537.03