Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $446.68 / $588.84	Facility		$309.03	$446.68	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $213.80 / $426.58	Professional		$165.96	$213.80	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $338.84 / $630.96	Professional		$151.36	$338.84	$630.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $245.47 / $524.81	Facility		$125.89	$245.47	$524.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $239.88 / $501.19	Professional		$128.82	$239.88	$501.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $131.83	Professional		$32.36	$33.11	$131.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $416.87 / $416.87	Facility		$251.19	$416.87	$416.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $288.40	Facility		$281.84	$281.84	$288.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $426.58 / $616.60	Professional		$281.84	$426.58	$616.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $446.68 / $851.14	Facility		$302.00	$446.68	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $398.11 / $524.81	Professional		$263.03	$398.11	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $489.78 / $870.96	Facility		$363.08	$489.78	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $588.84	Professional		$199.53	$309.03	$588.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $257.04 / $436.52	Professional		$229.09	$257.04	$436.52