Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $141.25 / $194.98	Facility		$85.11	$141.25	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $81.28 / $169.82	Professional		$34.67	$81.28	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $128.82 / $239.88	Professional		$45.71	$128.82	$239.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $102.33 / $204.17	Facility		$43.65	$102.33	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $141.25 / $223.87	Professional		$44.67	$141.25	$223.87
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 $66.07 / $138.04 / $154.88	Facility		$66.07	$138.04	$154.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $107.15	Facility		$104.71	$104.71	$107.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $223.87	Professional		$107.15	$165.96	$223.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $194.98	Professional		$91.20	$134.90	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $83.18 / $218.78	Professional		$47.86	$83.18	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $91.20 / $151.36	Professional		$79.43	$91.20	$151.36