Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $165.96 / $363.08	Facility		$69.18	$165.96	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $66.07 / $288.40	Professional		$47.86	$66.07	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $154.88 / $213.80	Facility		$56.23	$154.88	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $83.18 / $104.71	Professional		$38.90	$83.18	$104.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $91.20 / $251.19	Facility		$74.13	$91.20	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $91.20 / $204.17	Professional		$74.13	$91.20	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $70.79 / $77.62	Professional		$58.88	$70.79	$77.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $138.04	Facility		$74.13	$74.13	$138.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $128.82 / $218.78	Facility		$74.13	$128.82	$218.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $87.10	Professional		$66.07	$66.07	$87.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $109.65 / $199.53	Facility		$77.62	$109.65	$199.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $66.07 / $81.28	Professional		$61.66	$66.07	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $87.10 / $87.10	Facility		$74.13	$87.10	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $34.67 / $83.18	Professional		$30.90	$34.67	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $74.13 / $131.83	Professional		$33.11	$74.13	$131.83