Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $489.78 / $660.69	Facility		$281.84	$489.78	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $239.88 / $389.05	Professional		$190.55	$239.88	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Facility		$288.40	$288.40	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $288.40	Professional		$208.93	$208.93	$288.40
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 / $549.54 / $912.01	Professional		$251.19	$549.54	$912.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $331.13 / $363.08	Professional		$75.86	$331.13	$363.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $426.58 / $446.68	Facility		$346.74	$426.58	$446.68
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $436.52 / $446.68	Professional		$389.05	$436.52	$446.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $630.96 / $933.25	Facility		$380.19	$630.96	$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 $354.81 / $380.19 / $489.78	Professional		$354.81	$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 / $263.03 / $380.19	Professional		$186.21	$263.03	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $309.03 / $660.69	Professional		$269.15	$309.03	$660.69