Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $316.23 / $1,000.00	Facility		$204.17	$316.23	$1,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $331.13	Professional		$100.00	$147.91	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $338.84 / $446.68	Facility		$60.26	$338.84	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $194.98 / $239.88	Professional		$85.11	$194.98	$239.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $213.80 / $575.44	Facility		$169.82	$213.80	$575.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $467.74	Professional		$169.82	$213.80	$467.74
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 $169.82 / $169.82 / $323.59	Facility		$169.82	$169.82	$323.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $295.12 / $512.86	Facility		$169.82	$295.12	$512.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $204.17	Professional		$151.36	$151.36	$204.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $257.04 / $467.74	Facility		$177.83	$257.04	$467.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $151.36 / $190.55	Professional		$144.54	$151.36	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $204.17 / $204.17	Facility		$169.82	$204.17	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $70.79 / $190.55	Professional		$53.70	$70.79	$190.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $169.82 / $309.03	Professional		$75.86	$169.82	$309.03