Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $177.83	Facility		$128.82	$128.82	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $69.18 / $154.88	Professional		$57.54	$69.18	$154.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $123.03 / $218.78	Professional		$75.86	$123.03	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $70.79 / $79.43	Professional		$30.20	$70.79	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $144.54 / $147.91	Facility		$120.23	$144.54	$147.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $151.36 / $204.17	Professional		$93.33	$151.36	$204.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.04 / $181.97	Professional		$100.00	$138.04	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $177.83	Professional		$75.86	$109.65	$177.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $67.61 / $123.03	Professional		$64.57	$67.61	$123.03