Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $407.38 / $616.60	Facility		$245.47	$407.38	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $245.47 / $478.63	Professional		$112.20	$245.47	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $363.08 / $478.63	Facility		$169.82	$363.08	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $467.74 / $724.44	Facility		$151.36	$467.74	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $75.86	Professional		$50.12	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $416.87 / $691.83	Facility		$162.18	$416.87	$691.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $478.63 / $933.25	Facility		$316.23	$478.63	$933.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $60.26 / $60.26	Professional		$56.23	$60.26	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $645.65 / $1,148.15	Facility		$478.63	$645.65	$1,148.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89