Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $114.82 / $407.38	Facility		$58.88	$114.82	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $43.65 / $112.20	Professional		$19.95	$43.65	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $114.82	Facility		$107.15	$107.15	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $64.57 / $177.83	Professional		$28.18	$64.57	$177.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $38.90 / $158.49	Facility		$26.92	$38.90	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $141.25	Professional		$26.92	$41.69	$141.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $40.74	Professional		$32.36	$33.11	$40.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $102.33 / $125.89	Facility		$46.77	$102.33	$125.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $123.03 / $173.78	Facility		$79.43	$123.03	$173.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $109.65 / $158.49	Professional		$63.10	$109.65	$158.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $93.33 / $177.83	Facility		$77.62	$93.33	$177.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $66.07 / $87.10	Professional		$60.26	$66.07	$87.10
United Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $52.48 / $134.90	Professional		$28.84	$52.48	$134.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $70.79 / $120.23	Professional		$63.10	$70.79	$120.23