Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $630.96	Facility		$263.03	$263.03	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $245.47 / $446.68	Professional		$199.53	$245.47	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $281.84	Professional		$204.17	$204.17	$281.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $602.56 / $1,174.90	Facility		$257.04	$602.56	$1,174.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $524.81 / $933.25	Professional		$257.04	$524.81	$933.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $316.23 / $346.74	Professional		$75.86	$316.23	$346.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $398.11 / $407.38	Facility		$323.59	$398.11	$407.38
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $407.38 / $426.58	Professional		$389.05	$407.38	$426.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $602.56 / $891.25	Facility		$363.08	$602.56	$891.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $467.74	Professional		$338.84	$338.84	$467.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $354.81 / $457.09	Professional		$338.84	$354.81	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $660.69 / $660.69	Facility		$269.15	$660.69	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $269.15 / $389.05	Professional		$190.55	$269.15	$389.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $295.12 / $630.96	Professional		$245.47	$295.12	$630.96