Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $380.19 / $1,318.26	Facility		$204.17	$380.19	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $398.11	Professional		$131.83	$186.21	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $446.68 / $524.81	Facility		$169.82	$446.68	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $213.80 / $275.42	Professional		$97.72	$213.80	$275.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $251.19 / $630.96	Facility		$194.98	$251.19	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $251.19 / $537.03	Professional		$194.98	$251.19	$537.03
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 $204.17 / $204.17 / $302.00	Facility		$204.17	$204.17	$302.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $354.81 / $602.56	Facility		$204.17	$354.81	$602.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $245.47	Professional		$181.97	$181.97	$245.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $302.00 / $562.34	Facility		$213.80	$302.00	$562.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $181.97 / $245.47	Professional		$173.78	$181.97	$245.47
United Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $245.47 / $245.47	Facility		$204.17	$245.47	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $229.09	Professional		$85.11	$85.11	$229.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $204.17 / $363.08	Professional		$91.20	$204.17	$363.08