Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $446.68 / $616.60	Facility		$257.04	$446.68	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $234.42 / $380.19	Professional		$186.21	$234.42	$380.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $275.42	Professional		$199.53	$199.53	$275.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $616.60 / $1,122.02	Facility		$245.47	$616.60	$1,122.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $501.19 / $912.01	Professional		$245.47	$501.19	$912.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $302.00 / $331.13	Professional		$75.86	$302.00	$331.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $389.05 / $446.68	Facility		$316.23	$389.05	$446.68
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $398.11 / $446.68	Professional		$354.81	$398.11	$446.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $575.44 / $851.14	Facility		$346.74	$575.44	$851.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $436.52	Professional		$331.13	$331.13	$436.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $346.74 / $446.68	Professional		$323.59	$346.74	$446.68
United Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $630.96 / $630.96	Facility		$257.04	$630.96	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $257.04 / $371.54	Professional		$181.97	$257.04	$371.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $281.84 / $602.56	Professional		$263.03	$281.84	$602.56