Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $407.38 / $1,258.93	Facility		$204.17	$407.38	$1,258.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $416.87	Professional		$141.25	$208.93	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $501.19 / $691.83	Facility		$229.09	$501.19	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $239.88 / $323.59	Professional		$134.90	$239.88	$323.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $302.00 / $616.60	Facility		$218.78	$302.00	$616.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $316.23 / $676.08	Professional		$218.78	$316.23	$676.08
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 $218.78 / $218.78 / $416.87	Facility		$218.78	$218.78	$416.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $380.19 / $660.69	Facility		$218.78	$380.19	$660.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $263.03	Professional		$194.98	$194.98	$263.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $323.59 / $602.56	Facility		$229.09	$323.59	$602.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $194.98 / $251.19	Professional		$186.21	$194.98	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $263.03 / $263.03	Facility		$218.78	$263.03	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $123.03 / $263.03	Professional		$91.20	$123.03	$263.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $218.78 / $389.05	Professional		$97.72	$218.78	$389.05