Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $141.25 / $436.52	Facility		$50.12	$141.25	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $61.66 / $125.89	Professional		$30.20	$61.66	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $162.18 / $194.98	Facility		$79.43	$162.18	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $79.43 / $109.65	Professional		$14.45	$79.43	$109.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $75.86 / $199.53	Facility		$40.74	$75.86	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $83.18 / $199.53	Professional		$40.74	$83.18	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $58.88 / $75.86	Professional		$47.86	$58.88	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $144.54	Facility		$75.86	$75.86	$144.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $131.83 / $229.09	Facility		$75.86	$131.83	$229.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $91.20	Professional		$67.61	$67.61	$91.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $112.20 / $208.93	Facility		$79.43	$112.20	$208.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $67.61 / $83.18	Professional		$61.66	$67.61	$83.18
United Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $91.20 / $91.20	Facility		$75.86	$91.20	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $31.62 / $83.18	Professional		$12.59	$31.62	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $134.90	Professional		$33.88	$33.88	$134.90