Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $457.09 / $1,584.89	Facility		$239.88	$457.09	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $467.74	Professional		$162.18	$223.87	$467.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $549.54 / $776.25	Facility		$251.19	$549.54	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $257.04 / $331.13	Professional		$141.25	$257.04	$331.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $354.81 / $831.76	Facility		$239.88	$354.81	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $338.84 / $741.31	Professional		$239.88	$338.84	$741.31
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 $239.88 / $239.88 / $363.08	Facility		$239.88	$239.88	$363.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $426.58 / $724.44	Facility		$239.88	$426.58	$724.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $288.40	Professional		$218.78	$218.78	$288.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $363.08 / $660.69	Facility		$251.19	$363.08	$660.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $218.78 / $288.40	Professional		$204.17	$218.78	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $288.40 / $288.40	Facility		$239.88	$288.40	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $288.40	Professional		$102.33	$125.89	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $239.88 / $436.52	Professional		$109.65	$239.88	$436.52