Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $616.60 / $1,698.24	Facility		$371.54	$616.60	$1,698.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $263.03 / $549.54	Professional		$100.00	$263.03	$549.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $645.65 / $977.24	Facility		$295.12	$645.65	$977.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $331.13 / $436.52	Professional		$147.91	$331.13	$436.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $346.74 / $870.96	Facility		$281.84	$346.74	$870.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $354.81 / $776.25	Professional		$281.84	$354.81	$776.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $251.19 / $302.00	Professional		$75.86	$251.19	$302.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $537.03	Facility		$281.84	$281.84	$537.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $512.86 / $954.99	Facility		$281.84	$512.86	$954.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $338.84	Professional		$257.04	$257.04	$338.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $426.58 / $776.25	Facility		$295.12	$426.58	$776.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $257.04 / $338.84	Professional		$239.88	$257.04	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $338.84 / $338.84	Facility		$281.84	$338.84	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $316.23	Professional		$117.49	$117.49	$316.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $281.84 / $512.86	Professional		$125.89	$281.84	$512.86