Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $331.13 / $1,148.15	Facility		$173.78	$331.13	$1,148.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $338.84	Professional		$114.82	$162.18	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $389.05 / $457.09	Facility		$181.97	$389.05	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $186.21 / $251.19	Professional		$83.18	$186.21	$251.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $218.78 / $776.25	Facility		$173.78	$218.78	$776.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $218.78 / $489.78	Professional		$173.78	$218.78	$489.78
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 $173.78 / $173.78 / $263.03	Facility		$173.78	$173.78	$263.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $309.03 / $524.81	Facility		$173.78	$309.03	$524.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $208.93	Professional		$158.49	$158.49	$208.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $263.03 / $478.63	Facility		$186.21	$263.03	$478.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $158.49 / $194.98	Professional		$147.91	$158.49	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $208.93 / $208.93	Facility		$173.78	$208.93	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $194.98	Professional		$74.13	$74.13	$194.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $173.78 / $316.23	Professional		$79.43	$173.78	$316.23