Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $426.58 / $1,548.82	Facility		$363.08	$426.58	$1,548.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $245.47 / $794.33	Professional		$169.82	$245.47	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $562.34 / $691.83	Facility		$229.09	$562.34	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $281.84 / $371.54	Professional		$123.03	$281.84	$371.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $363.08 / $707.95	Facility		$263.03	$363.08	$707.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $398.11 / $724.44	Professional		$263.03	$398.11	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $234.42 / $281.84	Professional		$75.86	$234.42	$281.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $501.19	Facility		$263.03	$263.03	$501.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $467.74 / $794.33	Facility		$263.03	$467.74	$794.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $316.23	Professional		$239.88	$239.88	$316.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $398.11 / $724.44	Facility		$275.42	$398.11	$724.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $239.88 / $295.12	Professional		$223.87	$239.88	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $316.23 / $316.23	Facility		$263.03	$316.23	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $158.49 / $398.11	Professional		$144.54	$158.49	$398.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $263.03 / $478.63	Professional		$120.23	$263.03	$478.63