Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $194.98 / $363.08	Professional		$165.96	$194.98	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Facility		$239.88	$239.88	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $204.17 / $239.88	Professional		$28.84	$204.17	$239.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Professional		$380.19	$380.19	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $309.03 / $338.84	Professional		$245.47	$309.03	$338.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $660.69 / $660.69	Facility		$549.54	$660.69	$660.69
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $660.69 / $660.69	Professional		$549.54	$660.69	$660.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $33.88 / $338.84	Facility		$32.36	$33.88	$338.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $338.84	Professional		$32.36	$44.67	$338.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $31.62 / $31.62	Professional		$26.30	$31.62	$31.62
United Facility/Professional Facility Modifier Low / Median / High Price $2.00 / $112.20 / $263.03	Facility		$2.00	$112.20	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $165.96 / $275.42	Professional		$131.83	$165.96	$275.42