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 $151.36 / $213.80 / $363.08	Professional		$151.36	$213.80	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $295.12	Professional		$218.78	$218.78	$295.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $537.03 / $1,096.48	Facility		$223.87	$537.03	$1,096.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $467.74 / $831.76	Professional		$223.87	$467.74	$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 $309.03 / $380.19 / $478.63	Facility		$309.03	$380.19	$478.63
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $389.05 / $478.63	Professional		$346.74	$389.05	$478.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $562.34 / $831.76	Facility		$338.84	$562.34	$831.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $426.58	Professional		$323.59	$323.59	$426.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $436.52	Professional		$338.84	$338.84	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $588.84 / $588.84	Facility		$190.55	$588.84	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $338.84	Professional		$169.82	$239.88	$338.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $338.84 / $588.84	Professional		$275.42	$338.84	$588.84