Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $234.42 / $616.60	Facility		$125.89	$234.42	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $389.05	Professional		$72.44	$107.15	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $107.15 / $123.03	Facility		$60.26	$107.15	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $162.18 / $331.13	Professional		$100.00	$162.18	$331.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $123.03 / $281.84	Facility		$85.11	$123.03	$281.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $239.88	Professional		$85.11	$117.49	$239.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $186.21 / $218.78	Facility		$144.54	$186.21	$218.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $208.93 / $302.00	Facility		$147.91	$208.93	$302.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $213.80 / $316.23	Professional		$151.36	$213.80	$316.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $165.96 / $309.03	Facility		$138.04	$165.96	$309.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $114.82 / $199.53	Professional		$109.65	$114.82	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $134.90 / $251.19	Professional		$89.13	$134.90	$251.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $123.03 / $213.80	Professional		$112.20	$123.03	$213.80