Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $109.65 / $338.84	Facility		$79.43	$109.65	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $54.95 / $190.55	Professional		$38.02	$54.95	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $128.82 / $154.88	Facility		$54.95	$128.82	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $61.66 / $79.43	Professional		$29.51	$61.66	$79.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $70.79 / $154.88	Facility		$58.88	$70.79	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $72.44 / $154.88	Professional		$58.88	$72.44	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $61.66 / $75.86	Professional		$51.29	$61.66	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $112.20	Facility		$58.88	$58.88	$112.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $102.33 / $177.83	Facility		$58.88	$102.33	$177.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $70.79	Professional		$52.48	$52.48	$70.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $87.10 / $162.18	Facility		$61.66	$87.10	$162.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $52.48 / $66.07	Professional		$50.12	$52.48	$66.07
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $70.79 / $70.79	Facility		$58.88	$70.79	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $25.12 / $66.07	Professional		$24.55	$25.12	$66.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $58.88 / $104.71	Professional		$26.30	$58.88	$104.71