Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $616.60 / $870.96	Facility		$512.86	$616.60	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $831.76	Professional		$512.86	$512.86	$831.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $371.54 / $478.63	Facility		$169.82	$371.54	$478.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $524.81 / $724.44	Facility		$151.36	$524.81	$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
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $489.78 / $933.25	Facility		$371.54	$489.78	$933.25
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 $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11