Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $257.04	Professional		$87.10	$151.36	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $131.83 / $190.55	Professional		$70.79	$131.83	$190.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $338.84 / $724.44	Facility		$158.49	$338.84	$724.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $323.59 / $426.58	Professional		$199.53	$323.59	$426.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $251.19 / $346.74	Facility		$208.93	$251.19	$346.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $281.84 / $371.54	Professional		$177.83	$281.84	$371.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $371.54	Professional		$190.55	$263.03	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $69.18 / $114.82	Facility		$46.77	$69.18	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $141.25 / $288.40	Professional		$83.18	$141.25	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54