Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $602.56 / $1,584.89	Facility		$346.74	$602.56	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $257.04 / $537.03	Professional		$173.78	$257.04	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $602.56 / $794.33	Facility		$288.40	$602.56	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $316.23 / $389.05	Professional		$144.54	$316.23	$389.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $338.84 / $851.14	Facility		$275.42	$338.84	$851.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $758.58	Professional		$275.42	$346.74	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $239.88 / $288.40	Professional		$75.86	$239.88	$288.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $524.81	Facility		$275.42	$275.42	$524.81
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 / $331.13	Professional		$234.42	$245.47	$331.13
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