Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $147.91 / $151.36	Professional		$141.25	$147.91	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $302.00	Facility		$151.36	$151.36	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $245.47 / $588.84	Facility		$66.07	$245.47	$588.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $208.93 / $269.15	Professional		$181.97	$208.93	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $44.67 / $60.26	Professional		$30.20	$44.67	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $181.97 / $186.21	Facility		$151.36	$181.97	$186.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $151.36	Facility		$147.91	$147.91	$151.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $239.88	Professional		$117.49	$169.82	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $138.04 / $162.18	Professional		$125.89	$138.04	$162.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04