Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $281.84 / $338.84	Facility		$144.54	$281.84	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $165.96 / $229.09	Professional		$162.18	$165.96	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $162.18 / $302.00	Facility		$154.88	$162.18	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $190.55	Professional		$162.18	$162.18	$190.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $165.96 / $389.05	Facility		$154.88	$165.96	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $331.13	Professional		$138.04	$162.18	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $165.96 / $194.98	Professional		$64.57	$165.96	$194.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $177.83 / $309.03	Facility		$165.96	$177.83	$309.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $173.78 / $407.38	Facility		$128.82	$173.78	$407.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $204.17	Professional		$173.78	$173.78	$204.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $181.97 / $436.52	Facility		$151.36	$181.97	$436.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $181.97 / $181.97	Professional		$162.18	$181.97	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $181.97	Professional		$162.18	$162.18	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $162.18 / $213.80	Professional		$151.36	$162.18	$213.80