Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $128.82 / $154.88	Facility		$66.07	$128.82	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $74.13 / $93.33	Professional		$72.44	$74.13	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $74.13 / $141.25	Facility		$69.18	$74.13	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $83.18	Professional		$74.13	$74.13	$83.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $74.13 / $177.83	Facility		$70.79	$74.13	$177.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $74.13 / $151.36	Professional		$61.66	$74.13	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $75.86 / $89.13	Professional		$60.26	$75.86	$89.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $81.28 / $141.25	Facility		$74.13	$81.28	$141.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $81.28 / $186.21	Facility		$60.26	$81.28	$186.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $91.20	Professional		$77.62	$77.62	$91.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $83.18 / $204.17	Facility		$69.18	$83.18	$204.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $81.28 / $81.28	Professional		$74.13	$81.28	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $83.18	Professional		$74.13	$74.13	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $74.13 / $95.50	Professional		$70.79	$74.13	$95.50