Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $134.90 / $208.93	Facility		$87.10	$134.90	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $141.25	Professional		$57.54	$72.44	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $89.13	Professional		$64.57	$64.57	$89.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $181.97 / $380.19	Facility		$75.86	$181.97	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $158.49 / $281.84	Professional		$75.86	$158.49	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $102.33 / $114.82	Professional		$75.86	$102.33	$114.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $120.23 / $134.90	Facility		$107.15	$120.23	$134.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $134.90 / $134.90	Professional		$120.23	$134.90	$134.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $199.53 / $288.40	Facility		$117.49	$199.53	$288.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $154.88	Professional		$112.20	$112.20	$154.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $151.36	Professional		$112.20	$117.49	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $199.53 / $199.53	Facility		$79.43	$199.53	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $81.28 / $114.82	Professional		$57.54	$81.28	$114.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $117.49 / $204.17	Professional		$95.50	$117.49	$204.17