Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $602.56	Facility		$251.19	$251.19	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $190.55 / $331.13	Professional		$144.54	$190.55	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $204.17	Professional		$151.36	$151.36	$204.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $467.74 / $1,071.52	Facility		$199.53	$467.74	$1,071.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $436.52 / $758.58	Professional		$199.53	$436.52	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $288.40 / $316.23	Professional		$75.86	$288.40	$316.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $316.23 / $371.54	Facility		$295.12	$316.23	$371.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $371.54	Professional		$316.23	$371.54	$371.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $549.54 / $812.83	Facility		$331.13	$549.54	$812.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $436.52	Professional		$309.03	$309.03	$436.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Facility		$363.08	$363.08	$363.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $323.59 / $416.87	Professional		$309.03	$323.59	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $512.86 / $512.86	Facility		$158.49	$512.86	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $173.78 / $302.00	Professional		$147.91	$173.78	$302.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $269.15 / $575.44	Professional		$190.55	$269.15	$575.44