Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $288.40 / $398.11	Facility		$177.83	$288.40	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $251.19	Professional		$125.89	$147.91	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $229.09 / $407.38	Professional		$144.54	$229.09	$407.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $218.78 / $380.19	Facility		$144.54	$218.78	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $199.53 / $323.59	Professional		$128.82	$199.53	$323.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $87.10	Professional		$32.36	$33.11	$87.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $269.15 / $295.12	Facility		$223.87	$269.15	$295.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $275.42 / $398.11	Professional		$186.21	$275.42	$398.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $891.25 / $1,698.24	Facility		$575.44	$891.25	$1,698.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $338.84	Professional		$190.55	$263.03	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $812.83 / $1,479.11	Facility		$616.60	$812.83	$1,479.11
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $213.80 / $346.74	Professional		$134.90	$213.80	$346.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $134.90 / $223.87	Professional		$117.49	$134.90	$223.87