Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $338.84 / $2,238.72	Professional		$275.42	$338.84	$2,238.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $467.74	Facility		$354.81	$354.81	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $354.81 / $467.74	Professional		$302.00	$354.81	$467.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $537.03 / $676.08	Facility		$537.03	$537.03	$676.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $676.08	Professional		$537.03	$537.03	$676.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $512.86 / $562.34	Professional		$457.09	$512.86	$562.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $588.84 / $645.65	Facility		$524.81	$588.84	$645.65
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $616.60	Professional		$524.81	$524.81	$616.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $478.63 / $707.95	Facility		$42.66	$478.63	$707.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $60.26 / $478.63	Professional		$42.66	$60.26	$478.63
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $54.95 / $54.95	Professional		$44.67	$54.95	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $3.55 / $173.78 / $354.81	Facility		$3.55	$173.78	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $489.78	Professional		$257.04	$257.04	$489.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58