Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $660.69 / $741.31	Facility		$141.25	$660.69	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $346.74	Professional		$81.28	$114.82	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $204.17	Facility		$138.04	$138.04	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $204.17	Professional		$100.00	$100.00	$204.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $288.40 / $588.84	Facility		$120.23	$288.40	$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 / $158.49 / $177.83	Professional		$75.86	$158.49	$177.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $194.98 / $208.93	Facility		$165.96	$194.98	$208.93
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $208.93 / $208.93	Professional		$186.21	$208.93	$208.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $309.03 / $446.68	Facility		$181.97	$309.03	$446.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $229.09	Professional		$173.78	$173.78	$229.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $181.97 / $234.42	Professional		$173.78	$181.97	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $316.23 / $316.23	Facility		$95.50	$316.23	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $181.97	Professional		$89.13	$104.71	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $181.97 / $316.23	Professional		$147.91	$181.97	$316.23