Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $676.08	Facility		$281.84	$281.84	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $239.88 / $398.11	Professional		$190.55	$239.88	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $316.23	Professional		$234.42	$234.42	$316.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $630.96 / $1,230.27	Facility		$251.19	$630.96	$1,230.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $562.34 / $933.25	Professional		$251.19	$562.34	$933.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $331.13 / $371.54	Professional		$75.86	$331.13	$371.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $436.52 / $457.09	Facility		$426.58	$436.52	$457.09
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Professional		$346.74	$346.74	$346.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $645.65 / $933.25	Facility		$380.19	$645.65	$933.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $478.63	Professional		$363.08	$363.08	$478.63
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $380.19 / $489.78	Professional		$363.08	$380.19	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $645.65 / $645.65	Facility		$263.03	$645.65	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $269.15 / $380.19	Professional		$186.21	$269.15	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $309.03 / $660.69	Professional		$245.47	$309.03	$660.69