Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $575.44	Facility		$245.47	$245.47	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $316.23	Professional		$131.83	$181.97	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $194.98	Professional		$144.54	$144.54	$194.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $457.09 / $1,071.52	Facility		$190.55	$457.09	$1,071.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $446.68 / $741.31	Professional		$190.55	$446.68	$741.31
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 $302.00 / $371.54 / $407.38	Facility		$302.00	$371.54	$407.38
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $380.19 / $407.38	Professional		$338.84	$380.19	$407.38
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 $316.23 / $316.23 / $416.87	Professional		$316.23	$316.23	$416.87
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 $309.03 / $323.59 / $426.58	Professional		$309.03	$323.59	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $501.19 / $501.19	Facility		$151.36	$501.19	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $204.17 / $288.40	Professional		$144.54	$204.17	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $323.59 / $575.44	Professional		$269.15	$323.59	$575.44