Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $602.56 / $1,584.89	Facility		$275.42	$602.56	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $251.19 / $537.03	Professional		$181.97	$251.19	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $562.34 / $707.95	Facility		$281.84	$562.34	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $316.23 / $371.54	Professional		$144.54	$316.23	$371.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $338.84 / $1,230.27	Facility		$275.42	$338.84	$1,230.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $338.84 / $758.58	Professional		$275.42	$338.84	$758.58
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 $275.42 / $275.42 / $416.87	Facility		$275.42	$275.42	$416.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $478.63 / $831.76	Facility		$275.42	$478.63	$831.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $331.13	Professional		$245.47	$245.47	$331.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $416.87 / $758.58	Facility		$288.40	$416.87	$758.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $245.47 / $309.03	Professional		$234.42	$245.47	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $331.13 / $331.13	Facility		$275.42	$331.13	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $309.03	Professional		$114.82	$114.82	$309.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $275.42 / $489.78	Professional		$123.03	$275.42	$489.78