Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $186.21 / $295.12	Facility		$138.04	$186.21	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $112.20 / $223.87	Professional		$93.33	$112.20	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $107.15 / $120.23	Facility		$60.26	$107.15	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $316.23	Professional		$102.33	$165.96	$316.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $125.89 / $275.42	Facility		$89.13	$125.89	$275.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $125.89 / $251.19	Professional		$89.13	$125.89	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $67.61	Professional		$32.36	$33.11	$67.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $208.93 / $208.93	Facility		$151.36	$208.93	$208.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $199.53 / $281.84	Facility		$138.04	$199.53	$281.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $204.17 / $295.12	Professional		$141.25	$204.17	$295.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $154.88 / $295.12	Facility		$128.82	$154.88	$295.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $177.83 / $263.03	Professional		$120.23	$177.83	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $151.36 / $269.15	Professional		$95.50	$151.36	$269.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $117.49 / $199.53	Professional		$104.71	$117.49	$199.53