Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $537.03	Facility		$229.09	$229.09	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $190.55 / $316.23	Professional		$151.36	$190.55	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $229.09	Professional		$169.82	$169.82	$229.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $501.19 / $1,000.00	Facility		$199.53	$501.19	$1,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $446.68 / $741.31	Professional		$199.53	$446.68	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $269.15 / $295.12	Professional		$75.86	$269.15	$295.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $346.74 / $363.08	Facility		$338.84	$346.74	$363.08
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $512.86 / $758.58	Facility		$309.03	$512.86	$758.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $380.19	Professional		$288.40	$288.40	$380.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $302.00 / $389.05	Professional		$288.40	$302.00	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $524.81 / $524.81	Facility		$208.93	$524.81	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $213.80 / $302.00	Professional		$151.36	$213.80	$302.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $251.19 / $537.03	Professional		$194.98	$251.19	$537.03