Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $575.44	Facility		$245.47	$245.47	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $316.23	Professional		$125.89	$173.78	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Facility		$181.97	$181.97	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $181.97	Professional		$131.83	$131.83	$181.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $457.09 / $1,023.29	Facility		$194.98	$457.09	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $436.52 / $707.95	Professional		$194.98	$436.52	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $251.19 / $302.00	Professional		$75.86	$251.19	$302.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $288.40 / $363.08	Facility		$281.84	$288.40	$363.08
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $363.08 / $363.08	Professional		$288.40	$363.08	$363.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $524.81 / $776.25	Facility		$316.23	$524.81	$776.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $416.87	Professional		$302.00	$302.00	$416.87
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 $295.12 / $316.23 / $407.38	Professional		$295.12	$316.23	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $478.63 / $478.63	Facility		$144.54	$478.63	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $275.42	Professional		$134.90	$154.88	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $316.23 / $549.54	Professional		$257.04	$316.23	$549.54