Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $616.60	Facility		$257.04	$257.04	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $213.80 / $331.13	Professional		$151.36	$213.80	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $245.47	Professional		$177.83	$177.83	$245.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $524.81 / $1,096.48	Facility		$223.87	$524.81	$1,096.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $457.09 / $831.76	Professional		$223.87	$457.09	$831.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $295.12 / $323.59	Professional		$75.86	$295.12	$323.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $354.81 / $380.19	Facility		$302.00	$354.81	$380.19
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $380.19 / $380.19	Professional		$346.74	$380.19	$380.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $562.34 / $812.83	Facility		$331.13	$562.34	$812.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $436.52	Professional		$316.23	$316.23	$436.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Facility		$371.54	$371.54	$371.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $331.13 / $426.58	Professional		$316.23	$331.13	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $575.44 / $575.44	Facility		$173.78	$575.44	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $204.17 / $338.84	Professional		$162.18	$204.17	$338.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $331.13 / $588.84	Professional		$275.42	$331.13	$588.84