Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $239.88	Facility		$154.88	$154.88	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $154.88	Professional		$79.43	$93.33	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $144.54 / $263.03	Professional		$91.20	$144.54	$263.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $147.91 / $218.78	Facility		$95.50	$147.91	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $138.04 / $213.80	Professional		$81.28	$138.04	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $54.95	Professional		$32.36	$33.11	$54.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $169.82 / $173.78	Facility		$144.54	$169.82	$173.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $257.04	Professional		$117.49	$177.83	$257.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $218.78	Professional		$120.23	$165.96	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $128.82 / $223.87	Professional		$87.10	$128.82	$223.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $144.54	Professional		$75.86	$89.13	$144.54