Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $316.23 / $380.19	Facility		$213.80	$316.23	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $162.18 / $363.08	Professional		$117.49	$162.18	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $239.88 / $478.63	Professional		$151.36	$239.88	$478.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $316.23 / $1,479.11	Facility		$173.78	$316.23	$1,479.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $288.40 / $416.87	Professional		$173.78	$288.40	$416.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $269.15 / $309.03	Facility		$181.97	$269.15	$309.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $208.93	Facility		$204.17	$204.17	$208.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $323.59 / $436.52	Professional		$208.93	$323.59	$436.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,122.02 / $2,137.96	Facility		$776.25	$1,122.02	$2,137.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $281.84 / $389.05	Professional		$177.83	$281.84	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,548.82 / $2,754.23	Facility		$1,148.15	$1,548.82	$2,754.23
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $190.55 / $426.58	Professional		$144.54	$190.55	$426.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $177.83 / $295.12	Professional		$154.88	$177.83	$295.12