Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $245.47 / $389.05	Facility		$102.33	$245.47	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $141.25	Professional		$64.57	$83.18	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $100.00	Professional		$72.44	$72.44	$100.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $208.93 / $436.52	Facility		$89.13	$208.93	$436.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $181.97 / $323.59	Professional		$89.13	$181.97	$323.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $117.49 / $128.82	Professional		$75.86	$117.49	$128.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $147.91 / $158.49	Facility		$120.23	$147.91	$158.49
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $154.88 / $158.49	Professional		$138.04	$154.88	$158.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $223.87 / $331.13	Facility		$134.90	$223.87	$331.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $165.96	Professional		$125.89	$125.89	$165.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $131.83 / $173.78	Professional		$125.89	$131.83	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $229.09 / $229.09	Facility		$69.18	$229.09	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $134.90	Professional		$64.57	$75.86	$134.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $131.83 / $234.42	Professional		$109.65	$131.83	$234.42