Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $91.20 / $776.25	Professional		$70.79	$91.20	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $275.42	Professional		$85.11	$141.25	$275.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $147.91 / $229.09	Facility		$87.10	$147.91	$229.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $131.83 / $229.09	Professional		$77.62	$131.83	$229.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $75.86	Professional		$32.36	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $177.83 / $181.97	Facility		$151.36	$177.83	$181.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $186.21 / $263.03	Professional		$125.89	$186.21	$263.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $165.96 / $218.78	Professional		$125.89	$165.96	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $208.93	Professional		$75.86	$114.82	$208.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.92 / $100.00	Professional		$19.95	$26.92	$100.00