Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $416.87	Facility		$177.83	$177.83	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $467.74	Professional		$120.23	$154.88	$467.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $190.55	Professional		$138.04	$138.04	$190.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $389.05 / $741.31	Facility		$165.96	$389.05	$741.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $331.13 / $602.56	Professional		$165.96	$331.13	$602.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $199.53 / $218.78	Professional		$75.86	$199.53	$218.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $257.04 / $295.12	Facility		$208.93	$257.04	$295.12
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $263.03 / $295.12	Professional		$234.42	$263.03	$295.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $380.19 / $562.34	Facility		$229.09	$380.19	$562.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $288.40	Professional		$218.78	$218.78	$288.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $223.87 / $295.12	Professional		$213.80	$223.87	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $426.58 / $426.58	Facility		$128.82	$426.58	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $141.25 / $245.47	Professional		$120.23	$141.25	$245.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $223.87 / $398.11	Professional		$186.21	$223.87	$398.11