Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $478.63	Facility		$199.53	$199.53	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $257.04	Professional		$107.15	$138.04	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $144.54	Professional		$104.71	$104.71	$144.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $363.08 / $851.14	Facility		$144.54	$363.08	$851.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $346.74 / $562.34	Professional		$144.54	$346.74	$562.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $204.17 / $251.19	Professional		$75.86	$204.17	$251.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $288.40 / $295.12	Facility		$234.42	$288.40	$295.12
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Professional		$295.12	$295.12	$295.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $436.52 / $630.96	Facility		$257.04	$436.52	$630.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $323.59	Professional		$245.47	$245.47	$323.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Facility		$288.40	$288.40	$288.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $257.04 / $331.13	Professional		$245.47	$257.04	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $380.19 / $380.19	Facility		$114.82	$380.19	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $134.90 / $218.78	Professional		$107.15	$134.90	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $457.09	Professional		$213.80	$257.04	$457.09