Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $446.68 / $1,380.38	Facility		$245.47	$446.68	$1,380.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $218.78 / $467.74	Professional		$131.83	$218.78	$467.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $501.19 / $616.60	Facility		$245.47	$501.19	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $275.42 / $363.08	Professional		$120.23	$275.42	$363.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $295.12 / $812.83	Facility		$239.88	$295.12	$812.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $295.12 / $660.69	Professional		$239.88	$295.12	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $208.93 / $251.19	Professional		$75.86	$208.93	$251.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $446.68	Facility		$239.88	$239.88	$446.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $416.87 / $707.95	Facility		$239.88	$416.87	$707.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $288.40	Professional		$213.80	$213.80	$288.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $354.81 / $660.69	Facility		$251.19	$354.81	$660.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $213.80 / $269.15	Professional		$204.17	$213.80	$269.15
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 $67.61 / $100.00 / $269.15	Professional		$67.61	$100.00	$269.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $239.88 / $426.58	Professional		$107.15	$239.88	$426.58