Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $169.82	Facility		$70.79	$70.79	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $52.48 / $91.20	Professional		$36.31	$52.48	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $53.70	Professional		$39.81	$39.81	$53.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $128.82 / $302.00	Facility		$54.95	$128.82	$302.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $125.89 / $208.93	Professional		$54.95	$125.89	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $81.28 / $89.13	Professional		$72.44	$81.28	$89.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $93.33 / $107.15	Facility		$85.11	$93.33	$107.15
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $107.15 / $107.15	Professional		$93.33	$107.15	$107.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $154.88 / $229.09	Facility		$93.33	$154.88	$229.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $117.49	Professional		$89.13	$89.13	$117.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $91.20 / $120.23	Professional		$87.10	$91.20	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $141.25 / $141.25	Facility		$42.66	$141.25	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $46.77 / $83.18	Professional		$39.81	$46.77	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $91.20 / $162.18	Professional		$75.86	$91.20	$162.18