Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $331.13	Facility		$138.04	$138.04	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $181.97	Professional		$81.28	$120.23	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $120.23	Professional		$87.10	$87.10	$120.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $281.84 / $588.84	Facility		$120.23	$281.84	$588.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $251.19 / $446.68	Professional		$120.23	$251.19	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $141.25 / $173.78	Professional		$75.86	$141.25	$173.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $190.55 / $204.17	Facility		$162.18	$190.55	$204.17
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $204.17 / $204.17	Professional		$186.21	$204.17	$204.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $302.00 / $446.68	Facility		$181.97	$302.00	$446.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $223.87	Professional		$169.82	$169.82	$223.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $177.83 / $229.09	Professional		$169.82	$177.83	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $309.03 / $309.03	Facility		$93.33	$309.03	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $102.33 / $181.97	Professional		$89.13	$102.33	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $316.23	Professional		$147.91	$177.83	$316.23