Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $128.82 / $398.11	Facility		$89.13	$128.82	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $63.10 / $131.83	Professional		$40.74	$63.10	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $151.36 / $177.83	Facility		$60.26	$151.36	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $75.86 / $97.72	Professional		$34.67	$75.86	$97.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $85.11 / $234.42	Facility		$69.18	$85.11	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $85.11 / $190.55	Professional		$69.18	$85.11	$190.55
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 $69.18 / $69.18 / $128.82	Facility		$69.18	$69.18	$128.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $120.23 / $204.17	Facility		$69.18	$120.23	$204.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $83.18	Professional		$61.66	$61.66	$83.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $102.33 / $190.55	Facility		$72.44	$102.33	$190.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $61.66 / $77.62	Professional		$58.88	$61.66	$77.62
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $83.18 / $83.18	Facility		$69.18	$83.18	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $28.84 / $77.62	Professional		$25.12	$28.84	$77.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $69.18 / $123.03	Professional		$30.90	$69.18	$123.03