Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $398.11	Facility		$165.96	$165.96	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $194.98 / $316.23	Professional		$147.91	$194.98	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $309.03	Professional		$229.09	$229.09	$309.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $457.09 / $1,023.29	Facility		$125.89	$457.09	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $371.54 / $707.95	Professional		$125.89	$371.54	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $407.38 / $446.68	Professional		$75.86	$407.38	$446.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $194.98 / $416.87	Facility		$128.82	$194.98	$416.87
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $194.98 / $323.59	Facility		$147.91	$194.98	$323.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $208.93	Professional		$107.15	$107.15	$208.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $354.81	Professional		$112.20	$112.20	$354.81
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $630.96 / $630.96	Facility		$208.93	$630.96	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $208.93 / $346.74	Professional		$199.53	$208.93	$346.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $112.20 / $354.81	Professional		$93.33	$112.20	$354.81