Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $676.08	Facility		$281.84	$281.84	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $229.09 / $389.05	Professional		$177.83	$229.09	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Facility		$251.19	$251.19	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $251.19	Professional		$181.97	$181.97	$251.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $575.44 / $1,202.26	Facility		$239.88	$575.44	$1,202.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $501.19 / $891.25	Professional		$239.88	$501.19	$891.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $323.59 / $354.81	Professional		$75.86	$323.59	$354.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $407.38 / $436.52	Facility		$331.13	$407.38	$436.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $416.87 / $457.09	Professional		$380.19	$416.87	$457.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $616.60 / $891.25	Facility		$363.08	$616.60	$891.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $457.09	Professional		$346.74	$346.74	$457.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $363.08 / $467.74	Professional		$346.74	$363.08	$467.74
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $630.96 / $630.96	Facility		$190.55	$630.96	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $204.17 / $363.08	Professional		$177.83	$204.17	$363.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $363.08 / $645.65	Professional		$302.00	$363.08	$645.65