Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $177.83 / $281.84	Facility		$102.33	$177.83	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $100.00 / $371.54	Professional		$77.62	$100.00	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $141.25 / $229.09	Professional		$89.13	$141.25	$229.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $141.25 / $204.17	Facility		$91.20	$141.25	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $134.90 / $204.17	Professional		$85.11	$134.90	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $51.29	Professional		$32.36	$33.11	$51.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $158.49 / $177.83	Facility		$134.90	$158.49	$177.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $112.20	Facility		$109.65	$109.65	$112.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $239.88	Professional		$112.20	$158.49	$239.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $123.03 / $199.53	Professional		$95.50	$123.03	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $138.04 / $229.09	Professional		$83.18	$138.04	$229.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $85.11 / $154.88	Professional		$79.43	$85.11	$154.88