Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $346.74 / $1,202.26	Facility		$186.21	$346.74	$1,202.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $169.82 / $363.08	Professional		$120.23	$169.82	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $407.38 / $478.63	Facility		$190.55	$407.38	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $194.98 / $263.03	Professional		$89.13	$194.98	$263.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $229.09 / $831.76	Facility		$186.21	$229.09	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $229.09 / $512.86	Professional		$186.21	$229.09	$512.86
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 $186.21 / $186.21 / $275.42	Facility		$186.21	$186.21	$275.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $323.59 / $549.54	Facility		$186.21	$323.59	$549.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $223.87	Professional		$165.96	$165.96	$223.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $275.42 / $512.86	Facility		$194.98	$275.42	$512.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $165.96 / $208.93	Professional		$158.49	$165.96	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $223.87 / $223.87	Facility		$186.21	$223.87	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $208.93	Professional		$77.62	$77.62	$208.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $186.21 / $331.13	Professional		$83.18	$186.21	$331.13