Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $478.63 / $1,479.11	Facility		$346.74	$478.63	$1,479.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $234.42 / $501.19	Professional		$169.82	$234.42	$501.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $588.84 / $676.08	Facility		$263.03	$588.84	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $288.40 / $363.08	Professional		$131.83	$288.40	$363.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $302.00 / $794.33	Facility		$204.17	$302.00	$794.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $302.00 / $676.08	Professional		$204.17	$302.00	$676.08
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 $257.04 / $257.04 / $478.63	Facility		$257.04	$257.04	$478.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $446.68 / $758.58	Facility		$257.04	$446.68	$758.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $309.03	Professional		$229.09	$229.09	$309.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $380.19 / $707.95	Facility		$269.15	$380.19	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $229.09 / $288.40	Professional		$218.78	$229.09	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $309.03 / $309.03	Facility		$257.04	$309.03	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $288.40	Professional		$89.13	$107.15	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $257.04 / $457.09	Professional		$114.82	$257.04	$457.09