Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $144.54 / $269.15	Facility		$47.86	$144.54	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $61.66 / $100.00	Professional		$25.12	$61.66	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Facility		$42.66	$42.66	$42.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $79.43 / $173.78	Professional		$31.62	$79.43	$173.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $66.07 / $154.88	Facility		$26.30	$66.07	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $61.66 / $131.83	Professional		$25.12	$61.66	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $33.11 / $56.23	Professional		$17.78	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $154.88 / $162.18	Facility		$97.72	$154.88	$162.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $107.15 / $199.53	Professional		$37.15	$107.15	$199.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $85.11 / $162.18	Professional		$36.31	$85.11	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $223.87 / $302.00	Facility		$199.53	$223.87	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $74.13 / $151.36	Professional		$30.20	$74.13	$151.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $64.57 / $158.49	Professional		$23.99	$64.57	$158.49