Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $562.34	Facility		$234.42	$234.42	$562.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $181.97 / $346.74	Professional		$138.04	$181.97	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Facility		$263.03	$263.03	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $263.03	Professional		$194.98	$194.98	$263.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $457.09 / $1,023.29	Facility		$194.98	$457.09	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $426.58 / $724.44	Professional		$194.98	$426.58	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $275.42 / $309.03	Professional		$75.86	$275.42	$309.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $323.59 / $363.08	Facility		$288.40	$323.59	$363.08
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $363.08 / $363.08	Professional		$323.59	$363.08	$363.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $537.03 / $776.25	Facility		$316.23	$537.03	$776.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $398.11	Professional		$302.00	$302.00	$398.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Facility		$354.81	$354.81	$354.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $316.23 / $407.38	Professional		$302.00	$316.23	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $501.19 / $501.19	Facility		$204.17	$501.19	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $204.17 / $295.12	Professional		$144.54	$204.17	$295.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $257.04 / $549.54	Professional		$186.21	$257.04	$549.54