Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $245.47 / $1,548.82	Professional		$194.98	$245.47	$1,548.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $323.59	Facility		$245.47	$245.47	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $323.59	Professional		$208.93	$245.47	$323.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $537.03	Facility		$371.54	$371.54	$537.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $537.03	Professional		$371.54	$371.54	$537.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $363.08 / $436.52	Professional		$75.86	$363.08	$436.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $389.05 / $512.86	Facility		$363.08	$389.05	$512.86
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $389.05 / $457.09	Professional		$363.08	$389.05	$457.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $346.74 / $489.78	Facility		$30.20	$346.74	$489.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $41.69 / $346.74	Professional		$30.20	$41.69	$346.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Facility		$354.81	$354.81	$354.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $42.66 / $42.66	Professional		$35.48	$42.66	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $2.40 / $125.89 / $245.47	Facility		$2.40	$125.89	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $204.17 / $354.81	Professional		$181.97	$204.17	$354.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Professional		$295.12	$295.12	$295.12